Provider Demographics
NPI:1245087212
Name:MOHAMED, BIDOOR (RN, MSN, FNP)
Entity type:Individual
Prefix:MRS
First Name:BIDOOR
Middle Name:
Last Name:MOHAMED
Suffix:
Gender:F
Credentials:RN, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2343 NORWALK ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-3467
Mailing Address - Country:US
Mailing Address - Phone:313-445-8638
Mailing Address - Fax:
Practice Address - Street 1:2343 NORWALK ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3467
Practice Address - Country:US
Practice Address - Phone:313-445-8638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704341832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily