Healthcare Provider Details

I. General information

NPI: 1508819913
Provider Name (Legal Business Name): MOHAMED ABDELHAMEED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 06/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 E WALNUT ST
WASHINGTON IN
47501-2860
US

IV. Provider business mailing address

PO BOX 760
WASHINGTON IN
47501-0760
US

V. Phone/Fax

Practice location:
  • Phone: 812-254-2760
  • Fax: 812-257-8602
Mailing address:
  • Phone: 812-254-2760
  • Fax: 812-257-8602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number01053053A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME103049
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: