Provider Demographics
NPI:1629465331
Name:BAKEER, MOHAMED-ALY REDA (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED-ALY
Middle Name:REDA
Last Name:BAKEER
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 1:1441 JACKSON AVE APT 2B
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5771
Mailing Address - Country:US
Mailing Address - Phone:504-875-8855
Mailing Address - Fax:
Practice Address - Street 1:1441 JACKSON AVE APT 2B
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-5771
Practice Address - Country:US
Practice Address - Phone:504-875-8855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-20
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA326303208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program