Provider Demographics
NPI:1346293784
Name:MOHAMED, MOHAMED KAMEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:KAMEL
Last Name:MOHAMED
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 405633
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-5633
Mailing Address - Country:US
Mailing Address - Phone:888-563-3282
Mailing Address - Fax:605-677-3301
Practice Address - Street 1:501 N ELAM AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1118
Practice Address - Country:US
Practice Address - Phone:336-832-1100
Practice Address - Fax:336-832-0770
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200500089207RX0202X, 207R00000X, 207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13913OtherBCBS NC
NC5900956Medicaid
NC7539701OtherAETNA
NC806634OtherPARTNERS MEDICARE
NCE3678OtherMEDCOST
NC7539701OtherAETNA
NC5900956Medicaid