Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 48983 | AZ |
N | 207RP1001X | Pulmonary Disease | 48983 | AZ |
N | 207RP1001X | Pulmonary Disease | 57181-020 | WI |
NPI | 1003934175 |
---|---|
Provider Name | Mouhsen H Alhakeem |
First Address | Mesa, AZ 85202-4707 |
Second Address | Mesa, AZ 85202-4707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 22/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
61305 | DEAN HEALTH INSURANCE (01) | WI |