Provider Demographics
NPI:1093717837
Name:AL MOUNAYER, MUHAMMAD K (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:K
Last Name:AL MOUNAYER
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 1:2900 MAIN ST
Mailing Address - Street 2:APT. #201
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-4236
Mailing Address - Country:US
Mailing Address - Phone:203-368-6950
Mailing Address - Fax:
Practice Address - Street 1:GAYLORD HOSPITAL
Practice Address - Street 2:GAYLORD FARM RD.
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492
Practice Address - Country:US
Practice Address - Phone:203-284-2800
Practice Address - Fax:203-679-3598
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT043096207R00000X
NC2015-1230207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCQ268OtherMEDICARE ID
CTI32637Medicare UPIN
CT110009544Medicare ID - Type Unspecified