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NPI Code Detail

MEDICARE: DR. MOHAMMAD ELMUSA M.D.

MEDICARE: DR. MOHAMMAD ELMUSA 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
1207Q00000XFamily Medicine PhysicianMD443372PA

General Provider Information

NPI Number : 1215227541
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOHAMMAD ELMUSA M.D.
Provider Business Mailing Address
First Line : 130 N MAIN ST
Second Line :
City : UNION CITY
State : PA
Zip : 16438-1068
Country : US
Telephone Number : 814-665-8288
Fax Number :
Provider Business Practice Location Address
First Line : 130 N MAIN ST
Second Line :
City : UNION CITY
State : PA
Zip : 16438-1068
Country : US
Telephone Number : 814-665-8288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2011
Last Update Date : 10/05/2020

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