MEDICARE: DR. MOHAMMED HISHAM OBEIDIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	036838	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104987056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMED HISHAM OBEIDIN M.D.

Provider Business Mailing Address
First Line	:	1010 PRINCE AVE STE 400
Second Line	:
City	:	ATHENS
State	:	GA
Zip	:	30606-5805
Country	:	US
Telephone Number	:	706-425-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 PRINCE AVE STE 400
Second Line	:
City	:	ATHENS
State	:	GA
Zip	:	30606-5805
Country	:	US
Telephone Number	:	706-425-1400
Fax Number	:	706-548-0184

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	01/18/2023

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