Provider Demographics
NPI:1154842656
Name:MOHAMMED, SHELDON R
Entity Type:Individual
Prefix:
First Name:SHELDON
Middle Name:R
Last Name:MOHAMMED
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 1:609 EDGLEY AVE
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-5421
Mailing Address - Country:US
Mailing Address - Phone:215-432-5200
Mailing Address - Fax:
Practice Address - Street 1:609 EDGLEY AVE
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-5421
Practice Address - Country:US
Practice Address - Phone:215-432-5200
Practice Address - Fax:215-432-5200
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health