Provider Demographics
NPI:1942039177
Name:MOHAMED, ABDIRASHID A
Entity type:Individual
Prefix:
First Name:ABDIRASHID
Middle Name:A
Last Name:MOHAMED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 MYSTIC VALLEY PKWY APT W1006
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-7611
Mailing Address - Country:US
Mailing Address - Phone:617-792-3627
Mailing Address - Fax:
Practice Address - Street 1:3600 MYSTIC VALLEY PKWY APT W1006
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-7611
Practice Address - Country:US
Practice Address - Phone:617-792-3627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-27
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health