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NPI Code Detail

MEDICARE: MOHAMAD ALI CHEAITO MD

MEDICARE: MOHAMAD ALI CHEAITO 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 Program
2207P00000XEmergency Medicine PhysicianMD218228OR

General Provider Information

NPI Number : 1447927504
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOHAMAD ALI CHEAITO MD
Provider Business Mailing Address
First Line : 2700 NW STEWART PKWY
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-1214
Country : US
Telephone Number : 541-677-2185
Fax Number : 541-677-2291
Provider Business Practice Location Address
First Line : 2700 NW STEWART PKWY
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-1214
Country : US
Telephone Number : 541-677-2185
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2021
Last Update Date : 07/19/2024

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Directions to “ MOHAMAD ALI CHEAITO MD” Practice Location

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