MEDICARE: MOHAMED MOSTAFA ISMAEL M.D, M.P.H

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	2084P0800X	Psychiatry Physician	MD042775L	PA

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	:	1639140353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED MOSTAFA ISMAEL M.D, M.P.H

Provider Business Mailing Address
First Line	:	1554 COOK SCHOOL RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15241-2604
Country	:	US
Telephone Number	:	412-715-4627
Fax Number	:

Provider Business Practice Location Address
First Line	:	3811 OHARA ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-2561
Country	:	US
Telephone Number	:	412-344-4010
Fax Number	:

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	03/11/2016

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