Provider Demographics
NPI:1275095887
Name:MOHAMED, JAWAHIR IBRAHIM
Entity Type:Individual
Prefix:
First Name:JAWAHIR
Middle Name:IBRAHIM
Last Name:MOHAMED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3337 WESTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-3789
Mailing Address - Country:US
Mailing Address - Phone:614-377-0984
Mailing Address - Fax:
Practice Address - Street 1:3337 WESTERVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3789
Practice Address - Country:US
Practice Address - Phone:614-377-0984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider