Provider Demographics
NPI:1811218522
Name:MOHAMED, ALROMESA
Entity Type:Individual
Prefix:
First Name:ALROMESA
Middle Name:
Last Name:MOHAMED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2816 N SPARKMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1943
Mailing Address - Country:US
Mailing Address - Phone:520-891-0528
Mailing Address - Fax:520-908-7316
Practice Address - Street 1:2816 NORTH SPARKMAN BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-1943
Practice Address - Country:US
Practice Address - Phone:520-891-0528
Practice Address - Fax:520-908-7316
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver