Provider Demographics
NPI:1508819913
Name:ABDELHAMEED, MOHAMED (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:
Last Name:ABDELHAMEED
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 760
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47501-0760
Mailing Address - Country:US
Mailing Address - Phone:812-254-2760
Mailing Address - Fax:812-257-8602
Practice Address - Street 1:1314 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-2860
Practice Address - Country:US
Practice Address - Phone:812-254-2760
Practice Address - Fax:812-257-8602
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01053053A2084P0800X
FLME1030492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000213736OtherANTHEM
FL1451GOtherBLUE CROSS BLUE SHIELD
IN200310320Medicaid
IN200310320AMedicaid
FL000888600Medicaid
IN200310320AMedicaid
INCG3197Medicare PIN
ILP00454899Medicare PIN
G78157Medicare UPIN
FL000888600Medicaid
IN941190WWWMedicare ID - Type Unspecified
IN200310320Medicaid
ILDG7909Medicare PIN