Abedmahmoud, Issa
Abedmahmoud, Issa is an sole proprietor health care provider with primary practice located at 3020 S Park Ave , Herrin IL 62948-3721. He recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as his primary health care specialty. Abedmahmoud, Issa can be contacted via phone (618) 988-1877.Contact Information
Primary practice address
3020 S Park Ave
Herrin IL 62948-3721
Phone: (618) 988-1877
Fax: (618) 988-8578
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism | 207RE0101X | 036097793 | Illinois |
Profile Details
NPI number | 1528042975 |
---|---|
LBN Legal business name | Abedmahmoud, Issa |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Nov 30th, 2005 |
Last updated | Nov 18th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1528042975 | NPPES |
Other | 416686 | HEATHLINK | |
Other | 59806 | HEATHLINK | |
MEDICAID | 036097793 | HEATHLINK | |
Other | 10023061 | HEATHLINK | |
Other | 050625 | HEATHLINK |
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