Abedmahmoud, Issa

Abedmahmoud, Issa is an sole proprietor health care provider with primary practice located at 3020 S Park Ave , Herrin IL 62948-3721. He recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as his primary health care specialty. Abedmahmoud, Issa can be contacted via phone (618) 988-1877.

Contact Information

Primary practice address
3020 S Park Ave Herrin IL 62948-3721
Phone: (618) 988-1877
Fax: (618) 988-8578
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 036097793 Illinois

Profile Details

NPI number 1528042975
LBN Legal business name Abedmahmoud, Issa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2005
Last updated Nov 18th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528042975 NPPES
Other 416686 HEATHLINK
Other 59806 HEATHLINK
MEDICAID 036097793 HEATHLINK
Other 10023061 HEATHLINK
Other 050625 HEATHLINK

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