Provider Demographics
NPI:1932585536
Name:MOHAMED, FAYSAL M
Entity Type:Individual
Prefix:MR
First Name:FAYSAL
Middle Name:M
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 1:8831 E FLORIDA AVE,C 115
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247
Mailing Address - Country:US
Mailing Address - Phone:720-254-4949
Mailing Address - Fax:866-814-6401
Practice Address - Street 1:8831 E FLORIDA AVE,C 115
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247
Practice Address - Country:US
Practice Address - Phone:720-254-4949
Practice Address - Fax:866-814-6401
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-05
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLL -02313343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)