Provider Demographics
NPI:1154390953
Name:ANNOUS, MOUHAMAD O (MD)
Entity type:Individual
Prefix:DR
First Name:MOUHAMAD
Middle Name:O
Last Name:ANNOUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7801 YORK RD STE 240
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7446
Mailing Address - Country:US
Mailing Address - Phone:410-323-9214
Mailing Address - Fax:410-323-9215
Practice Address - Street 1:7801 YORK RD STE 240
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-323-9214
Practice Address - Fax:410-323-9215
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00234272086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD129241200Medicaid
MD595MMedicare ID - Type Unspecified
C57816Medicare UPIN