1891175626 NPI number — S M MONIR MOHAR M.D.

Table of content: S M MONIR MOHAR M.D. (NPI 1891175626)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891175626 NPI number — S M MONIR MOHAR M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOHAR
Provider First Name:
S M
Provider Middle Name:
MONIR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1891175626
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/04/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
930 MAR WALT DRIVE, UNIT C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WALTON BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32547-6706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-226-6801
Provider Business Mailing Address Fax Number:
877-413-5104

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2826 ROSS CLARK CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOTHAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36301-2017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-226-6801
Provider Business Practice Location Address Fax Number:
877-413-5104
Provider Enumeration Date:
06/06/2015

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: 2081P2900X , with the licence number:  MD50816 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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