Provider Demographics
NPI:1568430973
Name:AKBAR, MOHAMMAD M (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:M
Last Name:AKBAR
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 1:26 S CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-3001
Mailing Address - Country:US
Mailing Address - Phone:570-622-5751
Mailing Address - Fax:570-628-0841
Practice Address - Street 1:26 S CENTRE ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3001
Practice Address - Country:US
Practice Address - Phone:570-622-5751
Practice Address - Fax:570-628-0841
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036596L207K00000X, 207Y00000X, 207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000596359Medicaid
PA000596359Medicaid
PAB34386Medicare UPIN