Provider Demographics
NPI:1003486457
Name:MOHAMED, ALAA SALAH HAMADTALLA (MBBS)
Entity type:Individual
Prefix:
First Name:ALAA
Middle Name:SALAH HAMADTALLA
Last Name:MOHAMED
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:AL AZHAR STREET, MEDICAL CITY, ALSADD
Mailing Address - Street 2:BUILDING 306 , APT 108
Mailing Address - City:DOHA
Mailing Address - State:DOHA
Mailing Address - Zip Code:00000
Mailing Address - Country:QA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1399 WALTON WAY APT 118
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2680
Practice Address - Country:US
Practice Address - Phone:904-655-4952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA134142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology