MEDICARE: MOHEB M MOHAREB 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	208600000X	Surgery Physician	21380	WV
2	208600000X	Surgery Physician	MD437447	PA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760480941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHEB M MOHAREB MD

Provider Business Mailing Address
First Line	:	PO BOX 11392
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4004
Country	:	US
Telephone Number	:	866-949-1433
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 PINE RIDGE RD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-3900
Country	:	US
Telephone Number	:	239-348-4221
Fax Number	:

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	06/21/2018

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Directions to “ MOHEB M MOHAREB MD” Practice Location

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