Provider Demographics
NPI:1790325553
Name:RAMZOWN, MOHAMAD-AMIN HUSEIN (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMAD-AMIN
Middle Name:HUSEIN
Last Name:RAMZOWN
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 1:736 CAMBRIDGE STREET
Mailing Address - Street 2:SMC 8
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135
Mailing Address - Country:US
Mailing Address - Phone:617-789-5004
Mailing Address - Fax:617-789-5088
Practice Address - Street 1:736 CAMBRIDGE STREET
Practice Address - Street 2:SMC 8
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-789-5004
Practice Address - Fax:617-789-5088
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA282084390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program