DR. MOHAMMAD IMTIAZ MUBBASHAR MD NPI 1619497823

NPI Information

NPI: 1619497823
Provider Name: DR. MOHAMMAD IMTIAZ MUBBASHAR, MD
Classification: Psychiatry & Neurology - 2084P0804X
Specialization: Child & Adolescent Psychiatry
Entity Type: Individual
PECOS Registration: Yes
Address: 269 MEDICAL PARK BLVD
PETERSBURG, VA
ZIP 23805
Phone: (804) 861-0700

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NPI Details

DR. Mohammad Imtiaz Mubbashar, MD is a child and adolescent psychiatry psychiatry neurology in Petersburg, VA with 16 years of experience. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. DR. Mohammad Imtiaz Mubbashar, MD NPI is 1619497823. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

269 MEDICAL PARK BLVD
PETERSBURG, VA
ZIP 23805-337
Phone: (804) 861-0700

The NPI 1619497823 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/20/2017 and was last updated on 5/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	2021-02312	NORTH CAROLINA	Yes
3	2084P0800X	Psychiatry & Neurology	Psychiatry	2021-02312	NORTH CAROLINA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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