MEDICARE: DR. MOHAMMAD IDREES 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	174400000X	Specialist	MD033987L	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	:	1851383855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMAD IDREES MD

Provider Business Mailing Address
First Line	:	1949 LINCOLN WAY
Second Line	:
City	:	MCKEESPORT
State	:	PA
Zip	:	15131-2401
Country	:	US
Telephone Number	:	412-672-6800
Fax Number	:	412-672-6801

Provider Business Practice Location Address
First Line	:	1949 LINCOLN WAY
Second Line	:
City	:	MCKEESPORT
State	:	PA
Zip	:	15131-2401
Country	:	US
Telephone Number	:	412-672-6800
Fax Number	:	412-672-6801

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

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	01/23/2017

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