Healthcare Provider Details

I. General information

NPI: 1174947741
Provider Name (Legal Business Name): 3G MEDICAL CONSULTANT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2014
Last Update Date: 02/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 SECURITY BLVD
COLORADO SPRINGS CO
80911-1728
US

IV. Provider business mailing address

421 SECURITY BLVD
COLORADO SPRINGS CO
80911-1728
US

V. Phone/Fax

Practice location:
  • Phone: 719-368-6628
  • Fax: 719-368-6629
Mailing address:
  • Phone: 719-368-6628
  • Fax: 719-368-6629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberDR0052572
License Number StateCO

VIII. Authorized Official

Name: DR. RODNEY R MUHAMMAD
Title or Position: OWNER
Credential: D.O.
Phone: 301-258-1904