Provider Demographics
NPI:1083278477
Name:MOHAMED, MOHAMED MAALI GUMAA (MD)
Entity Type:Individual
Prefix:MR
First Name:MOHAMED MAALI
Middle Name:GUMAA
Last Name:MOHAMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 7, TRUE BLUE, SCHOOL OF MEDICINE, ST GEORGE'S
Mailing Address - Street 2:5TH FLOOR, MORRIS ALPERT BUILDING, PHARMACOLOGY DEPARTM
Mailing Address - City:ST. GEORGE'S
Mailing Address - State:ST. GEORGE'S
Mailing Address - Zip Code:00000
Mailing Address - Country:GD
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6420 CLAYTON ROAD SSM ST. MARY'S HOSPITAL
Practice Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117
Practice Address - Country:US
Practice Address - Phone:317-768-8778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-01
Last Update Date:2020-02-03
Deactivation Date:2019-12-23
Deactivation Code:
Reactivation Date:2020-02-03
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program