Provider Demographics
NPI:1497839203
Name:MOHAMMAD, YOUSEF M (MD)
Entity Type:Individual
Prefix:DR
First Name:YOUSEF
Middle Name:M
Last Name:MOHAMMAD
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 1:1654 UPHAM DR
Mailing Address - Street 2:430 MEANS HALL
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-1250
Mailing Address - Country:US
Mailing Address - Phone:614-293-6872
Mailing Address - Fax:614-293-4688
Practice Address - Street 1:456 W 10TH AVE
Practice Address - Street 2:STE 1C
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-6382
Practice Address - Fax:614-293-4724
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 07 9708174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2266195Medicaid
OH2266195Medicaid
OHH09572Medicare UPIN