Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | RES.003915 | OH |
NPI | 1023532702 |
---|---|
Provider Name | Abdulaziz Mohammad |
First Address | Beachwood, OH 44122-7543 |
Second Address | Cleveland, OH 44106-4905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2017 |
Last Update Date | 03/08/2017 |