Healthcare Provider Details

I. General information

NPI: 1124516414
Provider Name (Legal Business Name): UNKNOWN MOHAMMED ZUBAIR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MOHAMMED ZUBAIR MD

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date: 11/29/2018
Reactivation Date: 12/19/2018

III. Provider practice location address

421 US 31W BYP
BOWLING GREEN KY
42101-1775
US

IV. Provider business mailing address

421 US 31W BYP
BOWLING GREEN KY
42101-1775
US

V. Phone/Fax

Practice location:
  • Phone: 270-781-0151
  • Fax: 270-796-5688
Mailing address:
  • Phone: 270-782-0151
  • Fax: 270-793-5688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number61877
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: