MEDICARE: DR. MOHAMMAD YOUSEF ALKHATIB 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
1	207RI0200X	Infectious Disease Physician	01084895A	IN
2	207RI0200X	Infectious Disease Physician	A117007	CA

General Provider Information

NPI Number	:	1932436177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMAD YOUSEF ALKHATIB M.D.

Provider Business Mailing Address
First Line	:	8558 BROADWAY
Second Line	:
City	:	MERRILLVILLE
State	:	IN
Zip	:	46410-7032
Country	:	US
Telephone Number	:	219-392-7084
Fax Number	:	219-703-6854

Provider Business Practice Location Address
First Line	:	1400 S LAKE PARK AVE STE 304
Second Line	:
City	:	HOBART
State	:	IN
Zip	:	46342-6791
Country	:	US
Telephone Number	:	219-947-6638
Fax Number	:	219-947-6693

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

Provider Enumeration Date	:	11/09/2009
Last Update Date	:	11/09/2020

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