Individual ProviderMustafa ImranFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address700 High St, Williamsport, PA 17701-3198(570) 321-2850PECOS EnrollmentBased on the most recent information from CMS, provider Mustafa Imran is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1528268026Provider TypeIndividualFull NameImran, MustafaTitleDr.GenderMaleSole ProprietorNoEnumeration Date7/23/2007Last Updated1/31/2014Contact InformationPractice LocationPractice Address700 High St, Williamsport, PA 17701-3198Phone(570) 321-2850Fax(570) 321-2851Mailing LocationMailing Address1201 Grampian Blvd, Suite 1k, Williamsport, PA 17701-1900PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseMD449180PennsylvaniaCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseMD60085884Washington