MEDICARE: DR. MOURAD ABDELMESSIH M.D

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	35070805	OH
2	2084N0400X	Neurology Physician	35070805	OH

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	9339121	OTHER	OH	MEDICARE GROUP
3	00083088	OTHER	OH	MEDICARE RAILROAD
6	DA5551	OTHER	OH	MEDICARE RAILROAD GROUP

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0501309	OTHER	OH	UNITED HEALTHCARE
5	000000314456	OTHER	OH	ANTHEM

NPI Number	:	1184628950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOURAD ABDELMESSIH M.D

Provider Business Mailing Address
First Line	:	1916 TAMARACK RD
Second Line	:
City	:	NEWARK
State	:	OH
Zip	:	43055-2303
Country	:	US
Telephone Number	:	740-322-3794
Fax Number	:	740-522-0126

Provider Business Practice Location Address
First Line	:	1916 TAMARACK RD
Second Line	:
City	:	NEWARK
State	:	OH
Zip	:	43055-2303
Country	:	US
Telephone Number	:	740-522-6110
Fax Number	:	740-522-0126

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	05/14/2024

1916 TAMARACK RD
NEWARK, OH
43055-2303

Practice Phone: 740-522-6110
Practice Fax: 740-522-0126

1930 TAMARACK RD
NEWARK, OH
43055-2303