MEDICARE: MOHAMED H SESAY

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1629773577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED H SESAY

Provider Business Mailing Address
First Line	:	3482 W CANNON CREEK CIR
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-2500
Country	:	US
Telephone Number	:	801-949-7482
Fax Number	:

Provider Business Practice Location Address
First Line	:	3482 W CANNON CREEK CIR
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-2500
Country	:	US
Telephone Number	:	801-949-7482
Fax Number	:

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

Provider Enumeration Date	:	03/31/2023
Last Update Date	:	03/31/2023

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Directions to “ MOHAMED H SESAY ” Practice Location

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