1518585470 NPI number — MR. MESHREF AYED ALSHEHRI M.B.B.S

Table of content: MR. MESHREF AYED ALSHEHRI M.B.B.S (NPI 1518585470)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518585470 NPI number — MR. MESHREF AYED ALSHEHRI M.B.B.S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALSHEHRI
Provider First Name:
MESHREF
Provider Middle Name:
AYED
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.B.B.S
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518585470
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
01/19/2022
NPI Reactivation Date:
04/18/2022

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22 S. GREENE STREET,
Provider Second Line Business Mailing Address:
ROOM N3E09
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-328-6110
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22 S. GREENE STREET,
Provider Second Line Business Practice Location Address:
ROOM N3E09
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-328-8777
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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