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General NPI Number Information
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NPI Number | 1760480941
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Entity Type | Individual
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Provider Name | MOHEB M MOHAREB MD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 6101 PINE RIDGE RD
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City | NAPLES
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State | FL
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Zip | 34119-3900
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Country | US
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Telephone | 239-348-4221
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11392
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City | BELFAST
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State | ME
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Zip | 04915-4004
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Country | US
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Telephone | 866-949-1433
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 21380
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD437447
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License Number State | PA
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