| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MOIZ EHTESHAM | 1174140313 | 2020-07-04 |
Moiz Ehtesham is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1174140313. Registration indicates Moiz Ehtesham is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) Access to Cardiologists (Allopathic & Osteopathic Physicians, Internal Medicine) (Cardiovascular Disease (Internal Medicine),, ) (Allopathic & Osteopathic Physicians, Internal Medicine) (Internal Medicine: Cardiovascular Disease, ) (Specialist Network, ) (Internal Medicine Cardiovascular Disease, Allopathic & Osteopathic Physicians) (Internal Medicine, )
| Entity Type | Individual |
| Provider Name | Dr. Moiz Ehtesham MD |
| Practice Office Address | 2160 S 1ST AVE MAYWOOD, IL US |
| Practice Office Telephone | 8885847888 |
| Mailing Address | 2160 S 1ST AVE MAYWOOD, IL 601533328 US |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 207RC0000X PRIMARY | Access to Cardiologists Allopathic & Osteopathic Physicians Internal Medicine Cardiovascular Disease (Internal Medicine), Allopathic & Osteopathic Physicians Internal Medicine Internal Medicine: Cardiovascular Disease Specialist Network Internal Medicine Cardiovascular Disease Allopathic & Osteopathic Physicians Internal Medicine | 036164899
IL |