Provider Demographics
NPI:1164833927
Name:MOHAMED, ABDIWAHAB (MD)
Entity Type:Individual
Prefix:
First Name:ABDIWAHAB
Middle Name:
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 1:8009 AZUREWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-6291
Mailing Address - Country:US
Mailing Address - Phone:405-312-9411
Mailing Address - Fax:
Practice Address - Street 1:11713 SHADOW CREEK PKWY
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7198
Practice Address - Country:US
Practice Address - Phone:405-312-9411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR0761207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine