MEDICARE: MOHAMED M MUSA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172A00000X	Driver	112020686	CO

General Provider Information

NPI Number	:	1235993361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED M MUSA

Provider Business Mailing Address
First Line	:	2303 S HARLAN CT
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80227
Country	:	US
Telephone Number	:	347-439-1836
Fax Number	:

Provider Business Practice Location Address
First Line	:	2303 S HARLAN CT
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80227
Country	:	US
Telephone Number	:	347-439-1836
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2024
Last Update Date	:	02/08/2024

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Directions to “ MOHAMED M MUSA ” Practice Location

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