Provider Demographics
NPI:1699881680
Name:ALATTAR, MOHAMMED (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:
Last Name:ALATTAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4604 SPOTSYLVANIA PKWY STE 340
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-7767
Mailing Address - Country:US
Mailing Address - Phone:540-899-1615
Mailing Address - Fax:540-372-3525
Practice Address - Street 1:4604 SPOTSYLVANIA PKWY STE 340
Practice Address - Street 2:
Practice Address - City:FREDERICKSBRG
Practice Address - State:VA
Practice Address - Zip Code:22408-7767
Practice Address - Country:US
Practice Address - Phone:276-783-1827
Practice Address - Fax:276-783-2879
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235278207RC0200X, 207RP1001X, 207R00000X
MDD60563207RP1001X
MDD0060563174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30015993950002Medicaid
MD402960700Medicaid
MDQ181Medicare PIN
MDI47973Medicare UPIN