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NPI Code Detail

MEDICARE: MOHAMMED MAHMOUD AL-NUSAIRAT MD

MEDICARE: MOHAMMED MAHMOUD AL-NUSAIRAT MD
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
1390200000XStudent in an Organized Health Care Education/Training ProgramIN

General Provider Information

NPI Number : 1154263812
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOHAMMED MAHMOUD AL-NUSAIRAT MD
Provider Business Mailing Address
First Line : 2401 W UNIVERSITY AVE
Second Line :
City : MUNCIE
State : IN
Zip : 47303-3428
Country : US
Telephone Number : 765-747-3367
Fax Number : 765-751-1451
Provider Business Practice Location Address
First Line : 2401 W UNIVERSITY AVE
Second Line :
City : MUNCIE
State : IN
Zip : 47303-3428
Country : US
Telephone Number : 765-747-3367
Fax Number : 765-751-1451
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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