Provider Demographics
NPI:1093459786
Name:MUHAMMAD, ERIC ANTHONY
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:ANTHONY
Last Name:MUHAMMAD
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 1:141 LONGSTREET CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:COCHRAN
Mailing Address - State:GA
Mailing Address - Zip Code:31014
Mailing Address - Country:US
Mailing Address - Phone:478-317-9990
Mailing Address - Fax:
Practice Address - Street 1:141 LONGSTREET CHURCH RD
Practice Address - Street 2:
Practice Address - City:COCHRAN
Practice Address - State:GA
Practice Address - Zip Code:31014
Practice Address - Country:US
Practice Address - Phone:478-317-9990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional