Provider Demographics
NPI:1366016214
Name:ABDELSAID, MOHAMMED ANWAR SHERIF (RPH)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:ANWAR SHERIF
Last Name:ABDELSAID
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 SHELTON ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-0687
Mailing Address - Country:US
Mailing Address - Phone:706-726-6049
Mailing Address - Fax:
Practice Address - Street 1:2270 US HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3669
Practice Address - Country:US
Practice Address - Phone:706-726-6049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-16
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHR031112183500000X
GAPHRE009603333600000X
GARPH031112183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No333600000XSuppliersPharmacy