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General NPI Number Information
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NPI Number | 1235345430
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Entity Type | Individual
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Provider Name | FAWZU FUSAINI MOHAMMADU MD
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Gender | Male
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 11/02/2025
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Provider Practice Location Address
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Address Line | 1 DARLING DR STE 201
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City | AVON
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State | CT
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Zip | 06001-4277
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Country | US
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Telephone | 860-348-4520
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Fax | 860-261-6725
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Provider Business Mailing Address
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Address Line | 1 DARLING DR
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City | AVON
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State | CT
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Zip | 06001-4277
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Country | US
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Telephone | 860-348-4520
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Fax | 860-261-6725
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 44876
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 044876
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License Number State | CT
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