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General NPI Number Information
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NPI Number | 1972902732
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Entity Type | Individual
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Provider Name | MOHAMMED BERMO MD
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Gender | Male
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 180 FLOYD AVE
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City | ROCKY MOUNT
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State | VA
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Zip | 24151-1318
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Country | US
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Telephone | 540-489-6332
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Fax | 540-459-6518
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Provider Business Mailing Address
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Address Line | 180 FLOYD AVE
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City | ROCKY MOUNT
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State | VA
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Zip | 24151-1318
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Country | US
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Telephone | 540-489-6332
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Fax | 540-459-6518
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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 | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | R8865
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | R8865
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License Number State | TX
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