Provider Demographics
NPI:1235392416
Name:MOHIUDDIN, SOHAIB AMER (MD)
Entity Type:Individual
Prefix:
First Name:SOHAIB
Middle Name:AMER
Last Name:MOHIUDDIN
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:PO BOX 2752
Mailing Address - Street 2:MID-AMERICA RADIOLOGY
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-2752
Mailing Address - Country:US
Mailing Address - Phone:888-938-4706
Mailing Address - Fax:
Practice Address - Street 1:209 E WILLIAM ST
Practice Address - Street 2:SUITE 104B
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-4017
Practice Address - Country:US
Practice Address - Phone:888-938-4706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS76292085R0202X
PAMD4667852085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology