Provider Demographics
NPI:1326255399
Name:DAHMAN, MOHAMED I (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:I
Last Name:DAHMAN
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 1:3050 MACK RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-5379
Mailing Address - Country:US
Mailing Address - Phone:513-682-6980
Mailing Address - Fax:513-981-5783
Practice Address - Street 1:3050 MACK RD
Practice Address - Street 2:SUITE 205
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-5379
Practice Address - Country:US
Practice Address - Phone:513-682-6980
Practice Address - Fax:513-981-5783
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116017616390200000X
VA0101247868208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program