Provider Demographics
NPI:1467435099
Name:ADEEL, MOHAMMED S (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:S
Last Name:ADEEL
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 398
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47629-0398
Mailing Address - Country:US
Mailing Address - Phone:812-476-9983
Mailing Address - Fax:812-437-6197
Practice Address - Street 1:9355 WARRICK TRL
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-0015
Practice Address - Country:US
Practice Address - Phone:812-476-9983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-29
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01067000A208100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01184520Medicaid
INH19031Medicare UPIN
NY01184520Medicaid