NEERAJ MAHBOOB INTERNAL MEDICINE PSC (NPI# 1407867484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407867484 |
| Entity Type | Organization |
| Organization Name | NEERAJ MAHBOOB INTERNAL MEDICINE PSC |
| Other Organization Name | MEDICAL ASSOCIATES OF SOUTHEAST KENTUCKY |
| Practice Address |
515 Memorial Dr Ste 3 Manchester KY 40962-9157 |
| Practice Telephone | 6065990864 |
| Practice Fax Number | 6065990869 |
| Mailing Telephone | 6065990864 |
| Mailing Fax Number | 6065990869 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2012-10-11 |
| Authorized Official Name | NEERAJ MAHBOOB (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 6065990169 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
700127 | KY | Ambulatory Health Care Facilities |
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
900231 | KY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | MEDICARE RURAL HEALTH PROVIDER NUMBER | 18-8900 | 01 |
| KY | 7100137660 | 05 | |
| KY | 31-000797 | 05 |
| Other Name | Type Code |
|---|---|
| Medical Associates of Southeast Kentucky | Doing Business As Name - Organization |
| Street Address |
515 MEMORIAL DR STE 3 |
| City | MANCHESTER |
| State | KY |
| Zip Code | 40962-9157 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073524062 | Neeraj Mahboob | Internal Medicine | 515 Memorial Dr, Ste 3, Manchester, KY 40962-9157 | 2006-08-11 |
| 1285086520 | Rebecca J Green | Nurse Practitioner | 515 Memorial Dr, Suite 3, Manchester, KY 40962-9157 | 2016-07-11 |
| 1184015042 | Tracy Sizemore | Nurse Practitioner | 515 Memorial Dr, Manchester, KY 40962-9157 | 2015-02-13 |
| 1598166092 | Memorial Hospital, Inc. | Family Medicine | 515 Memorial Dr, Manchester, KY 40962-9157 | 2014-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609392356 | Angela Woods | Speech-Language Pathologist | 96 Woods Rd, Manchester, KY 40962 | 2017-08-15 |
| 1346627296 | Betty Alevras | Nurse Practitioner | 21 Crestview Drive, 204 Town Branch Road, Manchester, KY 40962 | 2015-04-29 |
| 1740525773 | Clay Community Pharmacy LLC | Pharmacy | 118 Clay Co S/c, Manchester, KY 40962 | 2012-12-03 |
| 1669758579 | Becky F Stubblefield | Nurse Practitioner | 65 Glenndale Drive, Manchester, KY 40962 | 2011-10-25 |
| 1891022315 | Sabrina Nicole Hacker | Occupational Therapist | 376 Manchester Square Shopping Centre, Manchester, KY 40962 | 2009-11-04 |
| 1114102167 | H&n Drug | Durable Medical Equipment & Medical Supplies | 515 Memorial Dr., Suite 2, Manchester, KY 40962 | 2008-01-08 |
| 1598944043 | Cumberland Valley Dist. Health Dept | Public Health or Welfare | 1983 Hwy 421, Manchester, KY 40962 | 2007-11-01 |
| 1023223203 | Dinah Lynn Sowders | Speech-Language Pathologist | 561 Mill Pond Drive, Manchester, KY 40962 | 2007-05-11 |
| 1104965300 | American Health Management, Inc. | Case Management | 2609 Hwy 80, Manchester, KY 40962 | 2007-02-05 |
| 1306902572 | Manchester Pharmacist Group LLC | Durable Medical Equipment & Medical Supplies | 415 Richmond Road, Unit B, Manchester, KY 40962 | 2006-12-29 |
| Find all providers in zip 40962 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023649514 | Memorial Hospital Inc | Clinic/Center | 485 Memorial Dr Ste 1, Manchester, KY 40962-9111 | 2020-02-03 |
| 1851765481 | Family Health Care Associates | Clinic/Center | 359 Old Us Highway 421 Unit B, Manchester, KY 40962-7538 | 2015-11-19 |
| 1811941008 | Steven D. Spady | Clinic/Center | 509 Memorial Dr, Suite 2, Manchester, KY 40962-6195 | 2006-05-20 |
| 1477184968 | Memorial Hospital Inc | Clinic/Center | 515 Memorial Dr Ste 2, Manchester, KY 40962-9157 | 2020-02-03 |
| 1548766025 | Woodland Wellness, Inc | Clinic/Center | 115 N Woodland St, Manchester, TN 37355-1573 | 2018-04-03 |
| 1700192028 | Coffee Medical Group LLC | Clinic/Center | 1615 Mcminnville Hwy, Manchester, TN 37355-3179 | 2010-08-24 |
| 1043537046 | Coffee Medical Group LLC | Clinic/Center | 482 Interstate Dr, Suite A, Manchester, TN 37355-3109 | 2010-04-29 |
| 1851541197 | Memorial Hospital | Clinic/Center | 509 Memorial Dr, Suite 2, Manchester, KY 40962-6195 | 2008-09-23 |
| 1255527040 | Kathryn A Phillips | Clinic/Center | 1020 Mcarthur St, Manchester, TN 37355-2453 | 2007-09-14 |
| 1003021858 | Glenn A Davis, Md (rhc) | Clinic/Center | 1020 Mcarthur St, Manchester, TN 37355-2453 | 2007-05-14 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 40962 |
Please comment or provide details below to improve the information on NEERAJ MAHBOOB INTERNAL MEDICINE PSC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.