Provider Demographics
NPI:1922799394
Name:ALJUMAILI, MUHASSAD (OD)
Entity Type:Individual
Prefix:DR
First Name:MUHASSAD
Middle Name:
Last Name:ALJUMAILI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 WESTPOINTE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-9126
Mailing Address - Country:US
Mailing Address - Phone:614-876-7850
Mailing Address - Fax:
Practice Address - Street 1:5200 WESTPOINTE PLAZA DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-9126
Practice Address - Country:US
Practice Address - Phone:614-876-7850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.007127261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care