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NPI Code Detail

MEDICARE: DR. GHULAM MOHAMMED MD

MEDICARE: DR. GHULAM MOHAMMED MD
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
1207R00000XInternal Medicine PhysicianME0063587FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1593122517OTHERCOMMERCIAL
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629037197
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GHULAM MOHAMMED MD
Provider Business Mailing Address
First Line : 555 N BYRON BUTLER PKWY
Second Line :
City : PERRY
State : FL
Zip : 32347-2315
Country : US
Telephone Number : 850-223-5400
Fax Number : 850-223-5401
Provider Business Practice Location Address
First Line : 555 N BYRON BUTLER PKWY
Second Line :
City : PERRY
State : FL
Zip : 32347-2315
Country : US
Telephone Number : 850-223-5400
Fax Number : 850-223-5401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2006
Last Update Date : 01/28/2014

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