Provider Demographics
NPI:1407952930
Name:EL-BAHESH, MUHAMMAD HISHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:HISHAM
Last Name:EL-BAHESH
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:CORLEY AVE
Mailing Address - Street 2:601-B
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35957
Mailing Address - Country:US
Mailing Address - Phone:256-593-3404
Mailing Address - Fax:256-593-0108
Practice Address - Street 1:CORLEY AVE
Practice Address - Street 2:601-B
Practice Address - City:BOAZ
Practice Address - State:AL
Practice Address - Zip Code:35957
Practice Address - Country:US
Practice Address - Phone:256-593-3404
Practice Address - Fax:256-593-0108
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16682ALABAMA208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51023852ELOtherBCBS
AL51023852ELOtherBCBS
AL51023852ELOtherBCBS