Provider Demographics
NPI:1629174966
Name:ALABRASH, MOHAMAD (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:
Last Name:ALABRASH
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 44090
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-6090
Mailing Address - Country:US
Mailing Address - Phone:443-678-1290
Mailing Address - Fax:443-678-1292
Practice Address - Street 1:5430 CAMPBELL BLVD
Practice Address - Street 2:STE 213
Practice Address - City:WHITE MARSH
Practice Address - State:MD
Practice Address - Zip Code:21162-5504
Practice Address - Country:US
Practice Address - Phone:443-678-1290
Practice Address - Fax:443-678-1292
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0037612207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5487919Medicaid
4084Medicare ID - Type Unspecified
E23844Medicare UPIN