Provider Demographics
NPI:1225747512
Name:AHMED, MOHAMUD
Entity Type:Individual
Prefix:
First Name:MOHAMUD
Middle Name:
Last Name:AHMED
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 1:1600 ARUNDEL ST APT 212
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-4599
Mailing Address - Country:US
Mailing Address - Phone:507-517-9142
Mailing Address - Fax:
Practice Address - Street 1:1600 ARUNDEL ST APT 212
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-4599
Practice Address - Country:US
Practice Address - Phone:507-517-9142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker