| Dr Ibrahim A Mourad, MD | |
|
19550 E 39th St S, Suite 400, Independence, MO 64057-2303 | |
| (816) 254-4800 | |
| (816) 254-4641 |
| Full Name | Dr Ibrahim A Mourad |
|---|---|
| Gender | Male |
| Speciality | Hospitalist |
| Experience | 45 Years |
| Location | 19550 E 39th St S, Independence, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164497525 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208M00000X | Hospitalist | 2009021594 (Missouri) | Secondary |
| 208M00000X | Hospitalist | 036-147746 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Memorial Hospital | Belleville, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Fairview Heights Medical Group Sc | 6800784083 | 386 |
| Entity Name | Fairview Heights Medical Group Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679503668 PECOS PAC ID: 6800784083 Enrollment ID: O20040309000650 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ibrahim A Mourad, MD 4500 Memorial Dr, Belleville, IL 62226-5360 Ph: (618) 257-6220 | Dr Ibrahim A Mourad, MD 19550 E 39th St S, Suite 400, Independence, MO 64057-2303 Ph: (816) 254-4800 |
Swapna Chebrolu, Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 19550 E 39th Street, Independence, MO 64057 Phone: 816-698-8158 | |
Jayne Lora Opena Bumgarner, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 4801 S Cliff Ave, Suite 300, Independence, MO 64055 Phone: 816-251-5200 Fax: 816-251-5299 | |
Dr. Yugandhar Kandimalla, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 19600 E 39th St S, Independence, MO 64057 Phone: 678-982-3590 Fax: 314-738-2088 |