Provider Demographics
NPI:1497280333
Name:ALHAMAR, MOHAMED (MD)
Entity Type:Individual
Prefix:MR
First Name:MOHAMED
Middle Name:
Last Name:ALHAMAR
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 1:2799 W GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2608
Mailing Address - Country:US
Mailing Address - Phone:313-916-2326
Mailing Address - Fax:313-916-9113
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-2326
Practice Address - Fax:313-916-9113
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2024-04-15
Deactivation Date:2017-12-04
Deactivation Code:
Reactivation Date:2018-02-06
Provider Licenses
StateLicense IDTaxonomies
MI4301503553207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology