Healthcare Provider Details

I. General information

NPI: 1184741407
Provider Name (Legal Business Name): ASHRAF MOHAMED, MD, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 09/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6502 GREENFIELD RD
DEARBORN MI
48126-1701
US

IV. Provider business mailing address

6502 GREENFIELD RD
DEARBORN MI
48126-1701
US

V. Phone/Fax

Practice location:
  • Phone: 313-582-7266
  • Fax: 313-582-7026
Mailing address:
  • Phone: 313-582-7266
  • Fax: 313-582-7026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ASHRAF E MOHAMED
Title or Position: PRESIDENT
Credential: M.D.
Phone: 313-582-7266