Healthcare Provider Details

I. General information

NPI: 1043765803
Provider Name (Legal Business Name): MOHAMED KONE M.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2016
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 S SAGINAW ST
FLINT MI
48503-3705
US

IV. Provider business mailing address

1109 CLEARVIEW DR
FLUSHING MI
48433-1415
US

V. Phone/Fax

Practice location:
  • Phone: 810-257-3709
  • Fax: 810-257-3755
Mailing address:
  • Phone: 810-922-4018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: