Healthcare Provider Details

I. General information

NPI: 1336384239
Provider Name (Legal Business Name): EL BAHESH, MUHAMMAD H. MD,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2008
Last Update Date: 12/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601B CORLEY AVE
BOAZ AL
35957-5957
US

IV. Provider business mailing address

601B CORLEY AVE
BOAZ AL
35957-5957
US

V. Phone/Fax

Practice location:
  • Phone: 256-593-3404
  • Fax: 256-593-0108
Mailing address:
  • Phone: 256-593-3404
  • Fax: 256-593-0108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MUHAMMAD H EL BAHESH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 256-593-3404