MEDICARE: MOHAMEDNAJIB MOHAMUD KAHIN SR.

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	1041C0700X	Clinical Social Worker	K5005539504209	WI

General Provider Information

NPI Number	:	1528792256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMEDNAJIB MOHAMUD KAHIN SR.

Provider Business Mailing Address
First Line	:	4920 S 14TH ST APT 102
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53221-3585
Country	:	US
Telephone Number	:	414-249-7396
Fax Number	:

Provider Business Practice Location Address
First Line	:	4920 S 14TH ST APT 102
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53221-3585
Country	:	US
Telephone Number	:	414-249-7396
Fax Number	:

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

Provider Enumeration Date	:	07/09/2022
Last Update Date	:	07/09/2022

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