Provider Demographics
NPI:1679818819
Name:JAMAL, MOHAMMAD HHH (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:HHH
Last Name:JAMAL
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 1:9500 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-2200
Mailing Address - Country:US
Mailing Address - Phone:216-444-2200
Mailing Address - Fax:
Practice Address - Street 1:1300 W 9TH ST
Practice Address - Street 2:APPARTMENT 232
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-1031
Practice Address - Country:US
Practice Address - Phone:216-544-3834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35099278208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery