MEDICARE: MOUSA S MOHAMED M.D.

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	207R00000X	Internal Medicine Physician	4301061794	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	OB56031	OTHER	MI	BSBSM GRP

General Provider Information

NPI Number	:	1801874029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOUSA S MOHAMED M.D.

Provider Business Mailing Address
First Line	:	4250 N SAGINAW ST STE A
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48505-5332
Country	:	US
Telephone Number	:	810-877-6115
Fax Number	:	810-877-6152

Provider Business Practice Location Address
First Line	:	425O N. SAGINAW ST.
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48505-5332
Country	:	US
Telephone Number	:	810-785-1121
Fax Number	:	810-785-3850

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

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	09/25/2025

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