Healthcare Provider Details

I. General information

NPI: 1669151361
Provider Name (Legal Business Name): TARIG MOHAMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 LONG POND RD
ROCHESTER NY
14626-4164
US

IV. Provider business mailing address

6600 S YALE AVE STE 1200
TULSA OK
74136-3361
US

V. Phone/Fax

Practice location:
  • Phone: 585-723-7746
  • Fax: 585-723-7834
Mailing address:
  • Phone: 918-501-8611
  • Fax: 918-488-6098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number48169
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: