Provider Demographics
NPI:1831202316
Name:ABIRI, MOHAMMED (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:
Last Name:ABIRI
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 1:725 RESERVOIR AVE
Mailing Address - Street 2:STE 306
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-4452
Mailing Address - Country:US
Mailing Address - Phone:401-944-1052
Mailing Address - Fax:401-944-1053
Practice Address - Street 1:725 RESERVOIR AVE
Practice Address - Street 2:STE 306
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-4452
Practice Address - Country:US
Practice Address - Phone:401-944-1052
Practice Address - Fax:401-944-1053
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI0083998208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI381OtherBC
RI9000038Medicaid
RI000111OtherBLUE CHIP
RI9000038Medicaid