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General NPI Number Information
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NPI Number | 1932470887
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Entity Type | Organization
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Legal Business Name | ADVANCED NORTHSHORE NEUROSURGICAL INSTITUTE
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 04/04/2012
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Provider Practice Location Address
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Address Line | 71380 HIGHWAY 21 104
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City | COVINGTON
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State | LA
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Zip | 70433-7245
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Country | US
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Telephone | 985-400-3210
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Fax | 855-553-6931
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Provider Business Mailing Address
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Address Line | 71380 HIGHWAY 21 104
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City | COVINGTON
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State | LA
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Zip | 70433-7245
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Country | US
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Telephone | 985-400-3210
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Fax | 855-553-6931
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Authorized Official
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Title or Position | OWNER MEMBER
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Name | DR. MOHAMMAD ALMUBASLAT
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Credential | M.D.
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Telephone | 985-400-3210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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