MEDICARE: MOHAMMAD I ABUTINEH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	29209	TN
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	29209	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043262538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMMAD I ABUTINEH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 338
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38101-0338
Country	:	US
Telephone Number	:	901-351-2120
Fax Number	:	901-761-4145

Provider Business Practice Location Address
First Line	:	6263 POPLAR AVE
Second Line	:	SUITE 1052
City	:	MEMPHIS
State	:	TN
Zip	:	38119-4701
Country	:	US
Telephone Number	:	901-351-2120
Fax Number	:	901-761-4145

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	06/29/2023

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