Individual ProviderMustafa Al-SabbaghRadiologyAllopathic & Osteopathic PhysiciansPractice Address1 Hospital Dr, Columbia, MO 65212-0001(573) 882-1026(573) 884-3300PECOS EnrollmentBased on the most recent information from CMS, provider Mustafa Al-Sabbagh is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1063753291Provider TypeIndividualFull NameAl-Sabbagh, MustafaCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date3/13/2013Last Updated8/16/2022Contact InformationPractice LocationPractice Address1 Hospital Dr, Columbia, MO 65212-0001Phone(573) 882-1026Fax(573) 884-4487Mailing LocationMailing AddressPO Box 843966, Kansas City, MO 64184-3966Phone(573) 884-3300Fax(573) 884-0943Provider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicense2017034849MissouriCode2085R0202XDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicenseD83036Maryland