Provider Demographics
NPI:1043317308
Name:COMPREHENSIVE NEUROLOGY & HEADACHE CENTER INC
Entity Type:Organization
Organization Name:COMPREHENSIVE NEUROLOGY & HEADACHE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:S
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-333-6250
Mailing Address - Street 1:4417 N HOLLAND SYLVANIA RD
Mailing Address - Street 2:STE 301C
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3518
Mailing Address - Country:US
Mailing Address - Phone:419-517-5333
Mailing Address - Fax:419-517-5335
Practice Address - Street 1:4417 N HOLLAND SYLVANIA RD
Practice Address - Street 2:STE 301C
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3518
Practice Address - Country:US
Practice Address - Phone:419-517-5333
Practice Address - Fax:419-517-5335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350839602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2823396Medicaid
OHDF6295OtherRAILROAD MEDICARE
OHDF6295OtherRAILROAD MEDICARE
OH9365311Medicare PIN