Healthcare Provider Details
I. General information
NPI: 1891635249
Provider Name (Legal Business Name): MAZAR MOHAMED YOUSIF MOHAMED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/28/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 CHILDRENS WAY # 512-19A
LITTLE ROCK AR
72202-3500
US
IV. Provider business mailing address
607 EASTVIEW CT UNIT Z2
SCHAUMBURG IL
60194-5124
US
V. Phone/Fax
- Phone: 501-364-1874
- Fax: 501-364-3196
- Phone: 469-418-1042
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: