Physician Compare National (NPI:1306891239)

HEALTHCARE PROVIDER: AL E. DEEB

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1306891239
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7315034667
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071102000179
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DEEB
	Individual professional last name
Provider First Name	AL
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1975
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1630 N PLAZA DR
	Group Practice or individual's line 1 address
City	TALLAHASSEE
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	323085346
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100254
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CAPITAL REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100135
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	TALLAHASSEE MEMORIAL HEALTHCARE
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y