Provider Demographics
NPI:1396792461
Name:ALOBEID, YASER (MD)
Entity type:Individual
Prefix:
First Name:YASER
Middle Name:
Last Name:ALOBEID
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 14067
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46411-4067
Mailing Address - Country:US
Mailing Address - Phone:219-769-1670
Mailing Address - Fax:219-738-6714
Practice Address - Street 1:3903 E US HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5810
Practice Address - Country:US
Practice Address - Phone:219-736-0900
Practice Address - Fax:219-769-5803
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058415207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200474460Medicaid
IN237650OtherMEDICARE PTAN
INI13279Medicare UPIN
IN200474460Medicaid
IN237730OMedicare PIN
IN237650 GROUP NUMBEMedicare PIN