Healthcare Provider Details

I. General information

NPI: 1487061768
Provider Name (Legal Business Name): MOHAMMAD ALSHOHA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 MONROE ST UNIT 103
SYLVANIA OH
43560-2771
US

IV. Provider business mailing address

5700 MONROE ST UNIT 103
SYLVANIA OH
43560-2771
US

V. Phone/Fax

Practice location:
  • Phone: 419-843-7996
  • Fax: 419-841-7704
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35.137580
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.137580
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberE-11585
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: