Individual
DR. MOUSA MAALOUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1340 BROAD AVE, SUITE 310, GULFPORT, MS 39501-2404
(228) 864-6629
(228) 864-6669
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 864-8454
(228) 865-1457
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16101
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119774
—
MS
01
—
110174412
RAILROAD MEDICARE
MS
01
—
P00722705
RAILROAD MEDICARE
MS
Enumeration date
08/20/2006
Last updated
07/10/2014
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