Provider Demographics
NPI:1235177809
Name:GARBA, MOHAMMAD LAWAL (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:LAWAL
Last Name:GARBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LAWAL
Other - Middle Name:
Other - Last Name:GARBA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1200 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1004
Mailing Address - Country:US
Mailing Address - Phone:336-832-4380
Mailing Address - Fax:336-832-4382
Practice Address - Street 1:1200 N ELM ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1004
Practice Address - Country:US
Practice Address - Phone:336-832-4380
Practice Address - Fax:336-832-4382
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-01304207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC58-2569828OtherUNITED HEALTHCARE
NC5902087Medicaid
NC7453359OtherAETNA
NC58-2569828OtherUNITED HEALTHCARE