Provider Demographics
NPI:1881403269
Name:AL HARBI, MUSTAFA
Entity type:Individual
Prefix:
First Name:MUSTAFA
Middle Name:
Last Name:AL HARBI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6473 MOUNTAINEER TRAIL CT
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3934
Mailing Address - Country:US
Mailing Address - Phone:614-218-8345
Mailing Address - Fax:
Practice Address - Street 1:6473 MOUNTAINEER TRAIL CT
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3934
Practice Address - Country:US
Practice Address - Phone:614-218-8345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide