Provider Demographics
NPI:1437300035
Name:AHMED, MOHAMED FAWZI
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:FAWZI
Last Name:AHMED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4497 PERSHING AVE
Mailing Address - Street 2:APT. # 510
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2527
Mailing Address - Country:US
Mailing Address - Phone:314-531-3255
Mailing Address - Fax:
Practice Address - Street 1:4497 PERSHING AVE
Practice Address - Street 2:APT. # 510
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2527
Practice Address - Country:US
Practice Address - Phone:314-531-3255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008021813231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist