Provider Demographics
NPI:1043667462
Name:MUHAMMAD, HADIYAH
Entity Type:Individual
Prefix:
First Name:HADIYAH
Middle Name:
Last Name:MUHAMMAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 RANDOLPH AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-2563
Mailing Address - Country:US
Mailing Address - Phone:651-434-4638
Mailing Address - Fax:
Practice Address - Street 1:1140 RANDOLPH AVE APT 14
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-2563
Practice Address - Country:US
Practice Address - Phone:651-434-4638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program