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General NPI Number Information
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NPI Number | 1942297270
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Entity Type | Individual
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Provider Name | IMAN MOHAMED M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 2520 ROBERT JONES WAY
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City | KALAMAZOO
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State | MI
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Zip | 49009-1904
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Country | US
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Telephone | 269-552-0420
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 SHAFFER STREET SUITE 002
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City | KALAMAZOO
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State | MI
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Zip | 49048
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Country | US
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Telephone |
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Fax | 269-552-2964
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 4301058580
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 35077273
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License Number State | OH
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