Provider Demographics
NPI:1891530606
Name:BERRO, MOUSSA MOHAMED (MD)
Entity type:Individual
Prefix:
First Name:MOUSSA
Middle Name:MOHAMED
Last Name:BERRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOUSSA
Other - Middle Name:
Other - Last Name:MOHAMED BERRO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1508 4TH AVE S APT 320
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1667
Mailing Address - Country:US
Mailing Address - Phone:659-262-9729
Mailing Address - Fax:
Practice Address - Street 1:625 19TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1900
Practice Address - Country:US
Practice Address - Phone:205-934-9666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program