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NPI Code Detail

MEDICARE: IKRAM MOHAMED

MEDICARE: IKRAM MOHAMED
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1902677925
Entity Type Code : Individual
Provider Name (Legal Business Name) : IKRAM MOHAMED
Provider Business Mailing Address
First Line : 2720 SUPERIOR DR NW STE 101
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-1775
Country : US
Telephone Number : 507-208-4007
Fax Number :
Provider Business Practice Location Address
First Line : 2720 SUPERIOR DR NW STE 101
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-1775
Country : US
Telephone Number : 507-208-4007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2024
Last Update Date : 01/09/2024

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