MEDICARE: MOHAMED RIAD HAJMURAD MD

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	2084N0400X	Neurology Physician	06830R	LA

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	:	1093709784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED RIAD HAJMURAD MD

Provider Business Mailing Address
First Line	:	1010 BAYOU TRACE DR
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-2500
Country	:	US
Telephone Number	:	318-473-8304
Fax Number	:	318-448-8877

Provider Business Practice Location Address
First Line	:	1010 BAYOU TRACE DR
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-2500
Country	:	US
Telephone Number	:	318-473-8304
Fax Number	:	318-448-8877

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

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	11/24/2020

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