Provider Demographics
NPI:1851683577
Name:MOHAMMAD, SAMYA (DO)
Entity Type:Individual
Prefix:MRS
First Name:SAMYA
Middle Name:
Last Name:MOHAMMAD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 HANOVER DRIVE
Mailing Address - Street 2:SUITE #201
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2247
Mailing Address - Country:US
Mailing Address - Phone:301-345-5600
Mailing Address - Fax:301-345-7715
Practice Address - Street 1:7300 HANOVER DRIVE
Practice Address - Street 2:SUITE #201
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2247
Practice Address - Country:US
Practice Address - Phone:301-345-5600
Practice Address - Fax:301-345-7715
Is Sole Proprietor?:No
Enumeration Date:2011-05-13
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-00979207RR0500X
VA390200000X
MDH85841207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2014-00979OtherSTATE LICENSE