MEDICARE: AHMED E. MOSTAFA 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
1	207R00000X	Internal Medicine Physician	35.083918	OH
2	207RP1001X	Pulmonary Disease Physician	35083918	OH
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	35083918	OH

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	:	1538139423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMED E. MOSTAFA MD

Provider Business Mailing Address
First Line	:	PO BOX 633448
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-3448
Country	:	US
Telephone Number	:	513-862-3452
Fax Number	:	513-862-3421

Provider Business Practice Location Address
First Line	:	10475 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-5201
Country	:	US
Telephone Number	:	513-865-1690
Fax Number	:	513-865-1691

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

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	03/24/2016

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