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General NPI Number Information
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NPI Number | 1639140353
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Entity Type | Individual
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Provider Name | MOHAMED MOSTAFA ISMAEL M.D, M.P.H
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Gender | Male
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 03/11/2016
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Provider Practice Location Address
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Address Line | 3811 OHARA ST
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City | PITTSBURGH
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State | PA
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Zip | 15213-2561
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Country | US
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Telephone | 412-344-4010
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Fax |
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Provider Business Mailing Address
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Address Line | 1554 COOK SCHOOL RD
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City | PITTSBURGH
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State | PA
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Zip | 15241-2604
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Country | US
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Telephone | 412-715-4627
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD042775L
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License Number State | PA
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