MEDICARE: LAYLA S MOHAMMED MB CHB

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	4301063542	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184630345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAYLA S MOHAMMED MB CHB

Provider Business Mailing Address
First Line	:	3621 S STATE ST
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48108-1633
Country	:	US
Telephone Number	:	734-647-5299
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 ARNET ST
Second Line	:
City	:	YPSILANTI
State	:	MI
Zip	:	48198-5753
Country	:	US
Telephone Number	:	734-484-7288
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	05/20/2020

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