Provider Demographics
NPI:1083917090
Name:ALSABBAGH, MOHAMMED EYAD YASEEN (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMED EYAD
Middle Name:YASEEN
Last Name:ALSABBAGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:M.EYAD
Other - Middle Name:
Other - Last Name:YASEEN ALSABBAGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10012 KENNERLY RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2197
Mailing Address - Country:US
Mailing Address - Phone:314-543-5911
Mailing Address - Fax:314-543-5914
Practice Address - Street 1:10012 KENNERLY RD STE 102
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2197
Practice Address - Country:US
Practice Address - Phone:314-543-5911
Practice Address - Fax:314-543-5914
Is Sole Proprietor?:No
Enumeration Date:2010-12-13
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017006373207RG0100X, 207RI0008X, 207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology