Provider Demographics
NPI:1750305538
Name:KALO, MOHAMMAD MOUHIB (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:MOUHIB
Last Name:KALO
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 628
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-0628
Mailing Address - Country:US
Mailing Address - Phone:740-574-1500
Mailing Address - Fax:740-574-9575
Practice Address - Street 1:8048 OHIO RIVER RD
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-1621
Practice Address - Country:US
Practice Address - Phone:740-574-1500
Practice Address - Fax:740-574-9575
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077644207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2199151Medicaid
KY64041478Medicaid
P00233795OtherRAILROAD MEDICARE
OH000000379094OtherBLUE CROSS & BLUE SHIELD
P00233795OtherRAILROAD MEDICARE
OH2199151Medicaid