MEDICARE: MOHAMED FARAH OMAR

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	342000000X	Transportation Network Company	O5605469000101	WI

General Provider Information

NPI Number	:	1518823699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED FARAH OMAR

Provider Business Mailing Address
First Line	:	1817 N 14TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53205-1641
Country	:	US
Telephone Number	:	414-499-9576
Fax Number	:

Provider Business Practice Location Address
First Line	:	1817 N 14TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53205-1641
Country	:	US
Telephone Number	:	414-499-9576
Fax Number	:

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

Provider Enumeration Date	:	01/01/2026
Last Update Date	:	01/01/2026

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