Provider Demographics
NPI:1598974123
Name:ALSOROGI, MOHAMMAD SAEED (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:SAEED
Last Name:ALSOROGI
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 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:201 E GRAY ST
Practice Address - Street 2:SUITE 1003
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3906
Practice Address - Country:US
Practice Address - Phone:502-629-2602
Practice Address - Fax:502-629-2603
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY418282084N0400X, 2084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000057058DDOtherHUMANA - NNS
KY6708250OtherCIGNA - NNS
KY50030637OtherPASSPORT & PASSPORT ADVANTAGE - NNS
KY7100060980Medicaid
KY000000693356OtherANTHEM - NNS
KY119119OtherSIHO - NNS
KY000000693356OtherANTHEM - NNS
KYP400031261Medicare PIN
KY119119OtherSIHO - NNS