Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 01055878A | IN |
N | 2084N0600X | Clinical Neurophysiologist | 01055878A | IN |
NPI | 1497756720 |
---|---|
Provider Name | Dr. Mahmood Ghiyath Alnahass |
First Address | Valparaiso, IN 46385-7760 |
Second Address | Valparaiso, IN 46383-2584 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 08/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200415900A | (05) | IN |
G64689 | (02) | IN |