Provider Demographics
NPI:1629029368
Name:ALHAJ, MOUSSA (MD)
Entity Type:Individual
Prefix:DR
First Name:MOUSSA
Middle Name:
Last Name:ALHAJ
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 2379
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2379
Mailing Address - Country:US
Mailing Address - Phone:606-408-6200
Mailing Address - Fax:606-408-6212
Practice Address - Street 1:613 23RD ST STE 340
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2879
Practice Address - Country:US
Practice Address - Phone:606-326-9441
Practice Address - Fax:606-326-0404
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36171207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY110222889OtherRAILROAD MEDICARE PIN
KY0560505OtherMEDICARE
KY00031003OtherMEDICARE
WV1810313000Medicaid
OH2275998Medicaid
KY64037294Medicaid
KY0560505OtherMEDICARE
WV1810313000Medicaid