Active NPI
Mohammad Mofreh S Altaleb
- Orthopaedic Surgery of the Spine Physician
- Baltimore, MD
National Provider Identifier
1134767643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery of the Spine Physician
- License
- D0088616
- Practice address
- 601 North Caroline Street / RM 5223
Baltimore, MD 21287-0882 - Phone
- (410) 955-3376
- NPI assigned
- Dec 16, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery of the Spine Physician | 207XS0117X | D0088616 | MD | Primary |
Addresses
Primary practice location
601 North Caroline Street / RM 5223
Baltimore, MD 21287-0882
Mailing address
414 Light Street
Apt 2702
Baltimore, MD 21202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0088616 | MD | MD | Orthopaedic Surgery of the Spine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576454400000",
"number": "1134767643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 LIGHT STREET",
"address_2": "APT 2702",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 NORTH CAROLINE STREET / RM 5223",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212870882",
"telephone_number": "410-955-3376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALTALEB",
"first_name": "MOHAMMAD",
"middle_name": "MOFREH S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-16",
"last_updated": "2019-12-16",
"certification_date": "2019-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0117X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
"state": "MD",
"license": "D0088616",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.