Individual
MOHAMED AYMAN ASFOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1530
(601) 984-1531
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1530
(601) 984-1531
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01841
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04426861
—
MS
01
—
15665175
BCBS
MS
01
—
P00728967
RR MEDICARE
MS
01
—
P01330231
RAILROAD MEDICARE PTAN
MS
Enumeration date
06/11/2006
Last updated
08/20/2014
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