Individual
MR. MOHAMMAD BASHAR MOURAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
32887
KY
207RN0300X
Nephrology Physician
Primary
32887
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000210578
ANTHEM PIN
IN
01
—
000000210578
ANTHEM PIN
KY
05
—
200367690
—
IN
05
—
64328875
—
KY
01
—
CJ7612
RAILROAD MEDICARE
IN
01
—
CJ7612
RAILROAD MEDIARE
KY
Enumeration date
07/06/2005
Last updated
07/20/2022
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