Provider Demographics
NPI:1497729032
Name:MOHAMMED, AHMED HASHIM (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:HASHIM
Last Name:MOHAMMED
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:PO BOX HH
Mailing Address - Street 2:
Mailing Address - City:WINNEBAGO
Mailing Address - State:NE
Mailing Address - Zip Code:68071-0767
Mailing Address - Country:US
Mailing Address - Phone:402-878-1223
Mailing Address - Fax:402-878-2535
Practice Address - Street 1:1 MAIN STREET
Practice Address - Street 2:PHS WINNEBAGO HOSPITAL
Practice Address - City:WINNEBAGO
Practice Address - State:NE
Practice Address - Zip Code:68071-0767
Practice Address - Country:US
Practice Address - Phone:402-878-1223
Practice Address - Fax:402-878-2535
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT034508207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8HD800Medicare PIN