MEDICARE: MUHAMMED A MUHAMMEDI 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
1	174400000X	Specialist	033153	GA
2	207RN0300X	Nephrology Physician	033153	GA

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

General Provider Information

NPI Number	:	1871584896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUHAMMED A MUHAMMEDI MD

Provider Business Mailing Address
First Line	:	1275 CLEVELAND AVE
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-3433
Country	:	US
Telephone Number	:	404-761-0819
Fax Number	:	404-768-2313

Provider Business Practice Location Address
First Line	:	1275 CLEVELAND AVE
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-3433
Country	:	US
Telephone Number	:	404-761-0819
Fax Number	:	47-682-3134

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	10/23/2019

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