Healthcare Provider Details

I. General information

NPI: 1740776988
Provider Name (Legal Business Name): MAHER M. AJOUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N STATE ST
JACKSON MS
39216-4500
US

IV. Provider business mailing address

PO BOX 11407 DEPT 2130
BIRMINGHAM AL
35246-2130
US

V. Phone/Fax

Practice location:
  • Phone: 601-815-2005
  • Fax:
Mailing address:
  • Phone: 601-815-2005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number31392
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: