Provider Demographics
NPI:1811253420
Name:NAEEM, MOHAMMAD IMRAN (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:IMRAN
Last Name:NAEEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MOHAMMAD
Other - Middle Name:IMRAN
Other - Last Name:NAEEM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MOHAMMAD I NAEEM MD
Mailing Address - Street 1:4430 HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3310
Mailing Address - Country:US
Mailing Address - Phone:985-626-3470
Mailing Address - Fax:985-674-5377
Practice Address - Street 1:4430 HIGHWAY 22 STE B
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471
Practice Address - Country:US
Practice Address - Phone:504-402-6881
Practice Address - Fax:985-626-3470
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3044962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry