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General NPI Number Information
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NPI Number | 1356064596
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Entity Type | Organization
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Legal Business Name | ELEPHANT GROUP SOLUTIONS INC
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Dates
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Enumeration Date | 09/22/2022
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 1528 WALNUT ST STE 200
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3602
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Country | US
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Telephone | 917-330-0939
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Fax |
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Provider Business Mailing Address
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Address Line | 1528 WALNUT ST STE 200
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3602
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Country | US
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Telephone | 917-330-0939
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Fax |
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Authorized Official
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Title or Position | SURGEON
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Name | DR. ALI MOHAMMAD
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Credential | DDS
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Telephone | 917-330-0939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number |
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License Number State |
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