Provider Demographics
NPI:1417243460
Name:MOHAMED MOUSSA, HALA (MD)
Entity Type:Individual
Prefix:
First Name:HALA
Middle Name:
Last Name:MOHAMED MOUSSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HALA
Other - Middle Name:
Other - Last Name:MINT ELMOCTAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2401 W BELVEDERE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5216
Mailing Address - Country:US
Mailing Address - Phone:410-601-8300
Mailing Address - Fax:410-601-8227
Practice Address - Street 1:5051 GREENSPRING AVE STE 202
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-4357
Practice Address - Country:US
Practice Address - Phone:410-601-8300
Practice Address - Fax:410-601-8227
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD956872084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program