Provider Demographics
NPI:1598151482
Name:AL-MOHAMAD, HUSSEIN (DO)
Entity Type:Individual
Prefix:DR
First Name:HUSSEIN
Middle Name:
Last Name:AL-MOHAMAD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 DAVIS ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-7022
Mailing Address - Country:US
Mailing Address - Phone:540-961-0218
Mailing Address - Fax:
Practice Address - Street 1:801 DAVIS ST STE 1
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-7022
Practice Address - Country:US
Practice Address - Phone:540-961-0218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-08
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102207350207RI0011X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program