Provider Demographics
NPI:1275224800
Name:MOHAMUD, RUUN
Entity Type:Individual
Prefix:
First Name:RUUN
Middle Name:
Last Name:MOHAMUD
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 1:620 E CENTER ST APT 7
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-4694
Mailing Address - Country:US
Mailing Address - Phone:608-228-1584
Mailing Address - Fax:
Practice Address - Street 1:620 E CENTER ST APT 7
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-4694
Practice Address - Country:US
Practice Address - Phone:608-228-1584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician