Healthcare Provider Details

I. General information

NPI: 1831892165
Provider Name (Legal Business Name): MOHAMED HAMMOUD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 TRAP FALLS RD STE 101
SHELTON CT
06484-4616
US

IV. Provider business mailing address

220 FANS ROCK RD
HAMDEN CT
06518-2017
US

V. Phone/Fax

Practice location:
  • Phone: 203-405-2591
  • Fax: 203-285-3157
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number84561
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: