Provider Demographics
NPI:1831835370
Name:MOHAMED, FAADUMO
Entity type:Individual
Prefix:
First Name:FAADUMO
Middle Name:
Last Name:MOHAMED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-8791
Mailing Address - Country:US
Mailing Address - Phone:571-620-8449
Mailing Address - Fax:
Practice Address - Street 1:612 MEADOWS DR
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-8791
Practice Address - Country:US
Practice Address - Phone:571-620-8449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker