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NPI Code Detail

MEDICARE: DR. MOHAMMED MAMDOUH AL-QASMI MD

MEDICARE: DR. MOHAMMED MAMDOUH AL-QASMI MD
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
12084N0400XNeurology Physician4301075825MI

General Provider Information

NPI Number : 1629027479
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOHAMMED MAMDOUH AL-QASMI MD
Provider Business Mailing Address
First Line : 1900 COLUMBUS AVE
Second Line :
City : BAY CITY
State : MI
Zip : 48708-6831
Country : US
Telephone Number : 989-667-3410
Fax Number : 989-667-3411
Provider Business Practice Location Address
First Line : 1900 COLUMBUS AVE
Second Line :
City : BAY CITY
State : MI
Zip : 48708-6831
Country : US
Telephone Number : 989-667-3410
Fax Number : 989-667-3411
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2006
Last Update Date : 01/13/2012

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