Provider Demographics
NPI:1629773577
Name:SESAY, MOHAMED H
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:H
Last Name:SESAY
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 1:3482 W CANNON CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-2500
Mailing Address - Country:US
Mailing Address - Phone:801-949-7482
Mailing Address - Fax:
Practice Address - Street 1:3482 W CANNON CREEK CIR
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-2500
Practice Address - Country:US
Practice Address - Phone:801-949-7482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program