Provider Demographics
NPI:1275988180
Name:AL KATEB, MOHAMAD (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:
Last Name:AL KATEB
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 1:810 NW 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4012
Mailing Address - Country:US
Mailing Address - Phone:352-333-5159
Mailing Address - Fax:352-333-3157
Practice Address - Street 1:5901 HARPER DR NE BLDG 1
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3569
Practice Address - Country:US
Practice Address - Phone:505-848-3730
Practice Address - Fax:505-848-3732
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN22903207R00000X
NM2021-1104207R00000X, 207RI0200X
NMMD2021-1104207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine