Provider Demographics
NPI:1265487771
Name:KURDI, MOSTAFA (MD,FCCP)
Entity type:Individual
Prefix:DR
First Name:MOSTAFA
Middle Name:
Last Name:KURDI
Suffix:
Gender:M
Credentials:MD,FCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 N LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47240-1398
Mailing Address - Country:US
Mailing Address - Phone:812-663-1331
Mailing Address - Fax:812-663-1320
Practice Address - Street 1:720 N LINCOLN ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240-1398
Practice Address - Country:US
Practice Address - Phone:812-663-1331
Practice Address - Fax:812-663-1320
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV24582207RC0200X, 207RS0012X, 207RP1001X
IN01093942A207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810021812Medicaid
WV3810021812Medicaid
NC5905035Medicaid
SCGP4505Medicaid
NC2056386Medicare ID - Type Unspecified
NC5904930OtherCAROLINA ACCESS
SCN0119CMedicaid
NCP00345067OtherRAILROAD MEDICARE
NCH80826Medicare UPIN