Provider Demographics
NPI:1205886595
Name:AKBIK, MOHAMAD J (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMAD
Middle Name:J
Last Name:AKBIK
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 742110
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2110
Mailing Address - Country:US
Mailing Address - Phone:901-529-7138
Mailing Address - Fax:901-590-3996
Practice Address - Street 1:2996 KATE BOND RD
Practice Address - Street 2:SUITE 209
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133
Practice Address - Country:US
Practice Address - Phone:901-529-7138
Practice Address - Fax:901-590-3996
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD11398174400000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3382996Medicare ID - Type Unspecified
TN3177574Medicare ID - Type Unspecified
TNB03775Medicare UPIN