Provider Demographics
NPI:1780418236
Name:MOHAMED, ASIM
Entity type:Individual
Prefix:
First Name:ASIM
Middle Name:
Last Name:MOHAMED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18101 OAKWOOD BLVD COREWELL HEALTH EAST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124
Mailing Address - Country:US
Mailing Address - Phone:313-436-2578
Mailing Address - Fax:
Practice Address - Street 1:18101 OAKWOOD BLVD COREWELL HEALTH EAST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124
Practice Address - Country:US
Practice Address - Phone:313-436-2578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2025-05-15
Deactivation Date:2025-05-15
Deactivation Code:
Reactivation Date:2025-05-15
Provider Licenses
StateLicense IDTaxonomies
MI4351053737207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine