Saif Mokhalad Faeq Al-Mudares, MD

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Jackson, MS

NPI 1073233276 · NPPES record last updated Oct 12, 2022

Key facts

NPI
1073233276
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-5102
NPI assigned
Aug 30, 2022
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5102

Other providers in Jackson, MS

All providers in Jackson, MS · Student in an Organized Health Care Education/Training Program in Mississippi

Sources for this page

Verify at the official NPI Registry.