Provider Demographics
NPI:1053428920
Name:CHISHTI, MUHAMMAD ISHAQ (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:ISHAQ
Last Name:CHISHTI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6680 CHIPPEWA ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-2537
Mailing Address - Country:US
Mailing Address - Phone:314-351-0101
Mailing Address - Fax:314-351-4697
Practice Address - Street 1:6680 CHIPPEWA ST
Practice Address - Street 2:SUITE 220
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-2537
Practice Address - Country:US
Practice Address - Phone:314-351-0101
Practice Address - Fax:314-351-4697
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2014-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR5030207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO319610516OtherMEDICARE PTAN
MO319610516Medicare PIN
MO319610516OtherMEDICARE PTAN
MO000005006Medicare ID - Type Unspecified