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NPI Code Detail

MEDICARE: MOUHAMAD ABDALLAH MD, PHD

MEDICARE: MOUHAMAD ABDALLAH MD, PHD
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
1207RC0000XCardiovascular Disease Physician41485KY
2207RC0000XCardiovascular Disease Physician35.090531OH
3207RI0011XInterventional Cardiology Physician35 090531OH

Other Identifiers

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

General Provider Information

NPI Number : 1972714251
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOUHAMAD ABDALLAH MD, PHD
Provider Business Mailing Address
First Line : 3170 KETTERING BLVD
Second Line : BUILDING B 3RD FLOOR
City : MORAINE
State : OH
Zip : 45439-1924
Country : US
Telephone Number : 937-991-3188
Fax Number :
Provider Business Practice Location Address
First Line : 5275 STATE ROUTE 122 STE 200
Second Line :
City : FRANKLIN
State : OH
Zip : 45005-9617
Country : US
Telephone Number : 513-217-6400
Fax Number : 937-557-6431
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2007
Last Update Date : 06/27/2025

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