Healthcare Provider Details

I. General information

NPI: 1487817011
Provider Name (Legal Business Name): MOHAMMED A HAMID DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 BROADWAY MID HUDSON PHYSICIANS, PC
KINGSTON NY
12401-4626
US

IV. Provider business mailing address

396 BROADWAY MID HUDSON PHYSICIANS, PC
KINGSTON NY
12401-4626
US

V. Phone/Fax

Practice location:
  • Phone: 845-331-3131
  • Fax: 845-334-2898
Mailing address:
  • Phone: 845-331-3131
  • Fax: 845-334-2898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number244430
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number244430
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: