Healthcare Provider Details

I. General information

NPI: 1578561643
Provider Name (Legal Business Name): MOHAMMED KABIR ABUBAKAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5255 LOUGHBORO RD NW SIBLEY MEMORIAL HOSPITAL
WASHINGTON DC
20016-2695
US

IV. Provider business mailing address

5255 LOUGHBORO RD NW
WASHINGTON DC
20016-2633
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-8569
  • Fax:
Mailing address:
  • Phone: 202-444-8569
  • Fax: 202-444-4747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number30658
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: