Provider Demographics
NPI:1972902732
Name:BERMO, MOHAMMED (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:
Last Name:BERMO
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 1:180 FLOYD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-1318
Mailing Address - Country:US
Mailing Address - Phone:540-489-6332
Mailing Address - Fax:540-459-6518
Practice Address - Street 1:180 FLOYD AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-1318
Practice Address - Country:US
Practice Address - Phone:540-489-6332
Practice Address - Fax:540-459-6518
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR8865207U00000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine