Provider Demographics
NPI:1467093948
Name:ALODAT, MOHAMED B
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:B
Last Name:ALODAT
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 1:1546 ROSEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3736
Mailing Address - Country:US
Mailing Address - Phone:216-421-4395
Mailing Address - Fax:
Practice Address - Street 1:1546 ROSEWOOD AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-3736
Practice Address - Country:US
Practice Address - Phone:216-421-4395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer