Provider Demographics
NPI:1407127558
Name:ALBAKOUR, MUSTAFA (MD)
Entity Type:Individual
Prefix:
First Name:MUSTAFA
Middle Name:
Last Name:ALBAKOUR
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:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-0726
Mailing Address - Country:US
Mailing Address - Phone:978-466-2692
Mailing Address - Fax:978-466-4754
Practice Address - Street 1:85 PRESCOTT ST STE 302
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2610
Practice Address - Country:US
Practice Address - Phone:774-420-2611
Practice Address - Fax:774-420-2616
Is Sole Proprietor?:No
Enumeration Date:2012-01-21
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA252546207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine