Organization
NEERAJ MAHBOOB INTERNAL MEDICINE PSC
Active
Other names
Medical Associates of Southeast Kentucky
Organization subpart
No
Provider details
NPI number
Authorized official
NEERAJ MAHBOOB MD (OWNER/PHYSICIAN)
(606) 599-0169
Entity
Organization
Contact information
Practice address
515 MEMORIAL DR, STE 3, MANCHESTER, KY 40962-9157
(606) 599-0864
(606) 599-0869
Mailing address
515 MEMORIAL DR, STE 3, MANCHESTER, KY 40962-9157
(606) 599-0864
(606) 599-0869
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
700127
KY
261QR1300X
Rural Health Clinic/Center
Primary
900231
KY
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18-8900
MEDICARE RURAL HEALTH PROVIDER NUMBER
KY
05
—
31-000797
—
KY
05
—
7100137660
—
KY
Enumeration date
08/11/2006
Last updated
02/12/2026
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