Provider Demographics
NPI:1467817809
Name:MOHAMED, ADAM
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:MOHAMED
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 1:2501 17TH AVE S APT 8
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4002
Mailing Address - Country:US
Mailing Address - Phone:952-688-8728
Mailing Address - Fax:
Practice Address - Street 1:2501 17TH AVE S APT 8
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4002
Practice Address - Country:US
Practice Address - Phone:952-688-8728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)