Provider Demographics
NPI:1396830915
Name:JARBOU, MOHAMMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:
Last Name:JARBOU
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 1:100 S KEENE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-6603
Mailing Address - Country:US
Mailing Address - Phone:573-777-9917
Mailing Address - Fax:573-777-9919
Practice Address - Street 1:100 S KEENE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6603
Practice Address - Country:US
Practice Address - Phone:573-777-9917
Practice Address - Fax:573-777-9919
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002014688207RC0200X, 207RS0012X, 207RP1001X, 207RC0200X, 207RP1001X, 207R00000X
HIMD-18384207RP1001X, 207RS0012X
IL036140915207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease