Provider Demographics
NPI:1093487795
Name:ELZUBIR, MOGAHID MOHAMED
Entity Type:Individual
Prefix:MR
First Name:MOGAHID
Middle Name:MOHAMED
Last Name:ELZUBIR
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 1:1124 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3043
Mailing Address - Country:US
Mailing Address - Phone:919-724-1000
Mailing Address - Fax:
Practice Address - Street 1:3001 CAMERON BLVD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-1059
Practice Address - Country:US
Practice Address - Phone:919-904-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)