Provider Demographics
NPI:1033991088
Name:HAMMAD, MOHAMAD
Entity Type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:
Last Name:HAMMAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4406 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-7412
Mailing Address - Country:US
Mailing Address - Phone:125-236-3234
Mailing Address - Fax:
Practice Address - Street 1:111 ADVENT CT
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7067
Practice Address - Country:US
Practice Address - Phone:919-424-6753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32683183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist