Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2008028015 | MO |
N | 111NI0900X | Internist | 2008028015 | MO |
Y | 207RI0011X | Interventional Cardiology | 35.136825 | OH |
NPI | 1083866149 |
---|---|
Provider Name | Mohammed Al-Amoodi |
First Address | Mission, KS 66202-1558 |
Second Address | Montgomery, OH 45242-4400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2008 |
Last Update Date | 30/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2565399 | (05) | OH |