Healthcare Provider Details

I. General information

NPI: 1114134632
Provider Name (Legal Business Name): MOHAMMAD MOBAYED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 S ROCHESTER RD STE 1400
ROCHESTER HILLS MI
48307-5160
US

IV. Provider business mailing address

PO BOX 7175
BLOOMFIELD MI
48302-7175
US

V. Phone/Fax

Practice location:
  • Phone: 248-494-4444
  • Fax: 586-690-7235
Mailing address:
  • Phone: 313-655-1616
  • Fax: 586-690-7235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberP6682
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number4301085805
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: