1669211355 NPI number — AHMAD ADNAN MOHAMMAD M.D.

Table of content: AHMAD ADNAN MOHAMMAD M.D. (NPI 1669211355)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669211355 NPI number — AHMAD ADNAN MOHAMMAD M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOHAMMAD
Provider First Name:
AHMAD
Provider Middle Name:
ADNAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669211355
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 HURLEY PLAZA, HURLEY MEDICAL CENTER
Provider Second Line Business Mailing Address:
GME OFFICE 10W
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-262-9437
Provider Business Mailing Address Fax Number:
810-262-7245

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 HURLEY PLAZA, HURLEY MEDICAL CENTER
Provider Second Line Business Practice Location Address:
GME OFFICE 10W
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-262-9437
Provider Business Practice Location Address Fax Number:
810-262-7245
Provider Enumeration Date:
05/22/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)