MEDICARE: MINA AYAD JACOB M.D.,FACC,FSCAI

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0002X	Adult Congenital Heart Disease Physician	31294	AL
2	207RC0000X	Cardiovascular Disease Physician	31294	AL
3	207RI0011X	Interventional Cardiology Physician	31294	AL
4	2086S0129X	Vascular Surgery Physician	31294	AL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1730132556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINA AYAD JACOB M.D.,FACC,FSCAI

Provider Business Mailing Address
First Line	:	1700 SPRING HILL AVE STE 100
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36604-1416
Country	:	US
Telephone Number	:	251-435-1200
Fax Number	:	251-435-6357

Provider Business Practice Location Address
First Line	:	1700 SPRING HILL AVE STE 100
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36604-1416
Country	:	US
Telephone Number	:	251-435-1200
Fax Number	:	251-435-6357

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	02/18/2021

67 WALNUT AVE
CLARK, NJ
07066-1640

Practice Phone: 732-388-7300
Practice Fax: 732-388-1330