Provider Demographics
NPI:1700198686
Name:MOHAMMED, ATHER FAREEDUDDIN (RPH)
Entity Type:Individual
Prefix:
First Name:ATHER
Middle Name:FAREEDUDDIN
Last Name:MOHAMMED
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 N BELFAST AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-4363
Mailing Address - Country:US
Mailing Address - Phone:207-622-6278
Mailing Address - Fax:207-622-0721
Practice Address - Street 1:2007 N BELFAST AVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-4363
Practice Address - Country:US
Practice Address - Phone:207-622-6278
Practice Address - Fax:207-621-0721
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist