Provider Demographics
NPI:1700869377
Name:MOHAMED, MOHAMUD SA (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMUD
Middle Name:SA
Last Name:MOHAMED
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3555 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 1080
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3912
Mailing Address - Country:US
Mailing Address - Phone:614-268-8164
Mailing Address - Fax:614-268-8406
Practice Address - Street 1:3555 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 1080
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3912
Practice Address - Country:US
Practice Address - Phone:614-268-8164
Practice Address - Fax:614-268-8406
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2023-03-24
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Provider Licenses
StateLicense IDTaxonomies
OH35082941208M00000X
OH35-08-2941207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2435207Medicaid
OHH93936Medicare UPIN
MO4116541Medicare PIN