Provider Demographics
NPI:1851482020
Name:GHOURI, MOHAMMAD BILAL (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:BILAL
Last Name:GHOURI
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 6237
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31917-6237
Mailing Address - Country:US
Mailing Address - Phone:706-407-5831
Mailing Address - Fax:706-407-5832
Practice Address - Street 1:2032 WYNNTON RD D
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-2483
Practice Address - Country:US
Practice Address - Phone:706-407-5831
Practice Address - Fax:706-407-5832
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA58739207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine