Provider Demographics
NPI:1891819074
Name:BEY, MOHAMMED ALBERT JR (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:ALBERT
Last Name:BEY
Suffix:JR
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 1:2100 WOODMERE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-2294
Mailing Address - Country:US
Mailing Address - Phone:504-328-1144
Mailing Address - Fax:
Practice Address - Street 1:2100 WOODMERE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2294
Practice Address - Country:US
Practice Address - Phone:504-328-1144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL07487R174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1385646Medicaid
LAD87042Medicare UPIN
LA1385646Medicaid