1710051479 NPI number — MOUHAMED A ALBAREE MD

Table of content: MOUHAMED A ALBAREE MD (NPI 1710051479)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710051479 NPI number — MOUHAMED A ALBAREE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALBAREE
Provider First Name:
MOUHAMED
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1710051479
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/20/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
98 RIVER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLAY CITY
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40312-1314
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-663-7788
Provider Business Mailing Address Fax Number:
606-663-7785

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
98 RIVER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLAY CITY
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40312-1314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-663-7788
Provider Business Practice Location Address Fax Number:
606-663-7785
Provider Enumeration Date:
11/17/2006

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: 207R00000X , with the licence number:  29137 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 35001957 . This is a "RURAL HEALTH MEDICAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 183941 . This is a "RURAL HEALTH MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00244477 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 64291370 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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