Healthcare Provider Details

I. General information

NPI: 1497756720
Provider Name (Legal Business Name): MAHMOOD GHIYATH ALNAHASS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date: 03/23/2006
Reactivation Date: 04/12/2006

III. Provider practice location address

1551 STURDY RD
VALPARAISO IN
46383-7883
US

IV. Provider business mailing address

206 GLENCOE DR
VALPARAISO IN
46385-7760
US

V. Phone/Fax

Practice location:
  • Phone: 219-531-6571
  • Fax: 219-462-0765
Mailing address:
  • Phone: 219-477-4273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number01055878A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number01055878A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: