| Mohammad Idrees Md, P.a. | |
|
1454 Belaire Lane N.e. Palm Bay FL 32905 | |
| (321) 723-2121 | |
| (321) 723-7478 |
| Full Name | Mohammad Idrees Md, P.a. |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 1454 Belaire Lane N.e., Palm Bay, Florida |
| Authorized Official Name and Position | Amber Lee Tedder (MEDICAL ASSISTANT) |
| Authorized Official Contact | 3217232121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohammad Idrees Md, P.a. 1454 Belaire Lane N.e. Palm Bay FL 32905 Ph: (321) 723-2121 | Mohammad Idrees Md, P.a. 1454 Belaire Lane N.e. Palm Bay FL 32905 Ph: (321) 723-2121 |
| NPI Number | 1326308313 |
|---|---|
| Provider Enumeration Date | 05/23/2012 |
| Last Update Date | 05/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326308313 | NPI | - | NPPES |
| #054484100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | ME22385 (Florida) | Primary |
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