Provider Demographics
NPI:1063488815
Name:NAEEM, MOHAMMAD AKBAR (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:AKBAR
Last Name:NAEEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035
Mailing Address - Country:US
Mailing Address - Phone:440-322-4333
Mailing Address - Fax:440-322-7717
Practice Address - Street 1:418 E BROAD ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035
Practice Address - Country:US
Practice Address - Phone:440-322-4333
Practice Address - Fax:440-322-7717
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35034213N207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000127320OtherBLUE CROSS BLUE SHIELD
OH0196890Medicaid
A73792Medicare UPIN
OH0196890Medicaid