Provider Demographics
NPI:1952559320
Name:MOHD, HAMZAH (MD,)
Entity type:Individual
Prefix:
First Name:HAMZAH
Middle Name:
Last Name:MOHD
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
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Mailing Address - Street 1:178 BRAESHIRE DR
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-5401
Mailing Address - Country:US
Mailing Address - Phone:224-478-8620
Mailing Address - Fax:
Practice Address - Street 1:621 S NEW BALLAS RD STE 7018B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8256
Practice Address - Country:US
Practice Address - Phone:314-251-4949
Practice Address - Fax:314-251-4368
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5301102241207R00000X
PAMD444875207RI0200X
MI4301102241208M00000X
MO2017018907207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist