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General NPI Number Information
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NPI Number | 1689101131
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Entity Type | Individual
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Provider Name | MOHAMED MOHAMED TRANSPORTATION
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Gender | Male
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Dates
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Enumeration Date | 05/15/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5701 SHINGLE CREEK PKWY STE 600F
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City | BROOKLYN CENTER
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State | MN
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Zip | 55430-2355
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Country | US
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Telephone | 763-703-9444
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Fax |
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Provider Business Mailing Address
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Address Line | 5701 SHINGLE CREEK PKWY STE 600F
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City | BROOKLYN CENTER
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State | MN
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Zip | 55430-2355
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Country | US
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Telephone | 763-703-9444
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Fax |
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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 | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | H238080318513
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License Number State | MN
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