Healthcare Provider Details

I. General information

NPI: 1851340319
Provider Name (Legal Business Name): MOHAMMED M AHMED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 W ROLLING XRDS STE 100
CATONSVILLE MD
21228-6277
US

IV. Provider business mailing address

10433 KINGSBRIDGE RD
ELLICOTT CITY MD
21042-5853
US

V. Phone/Fax

Practice location:
  • Phone: 410-869-0100
  • Fax: 410-601-7317
Mailing address:
  • Phone: 443-739-7129
  • Fax: 410-601-7317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0044796
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: