Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 10996 | WV |
Y | 208800000X | Urologist | D0020015 | MD |
NPI | 1023293826 |
---|---|
Provider Name | Mohammed M Mohiuddin |
First Address | Frederick, MD 21701 |
Second Address | Frederick, MD 21701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2007 |
Last Update Date | 31/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3003208000 | (05) | WV |
4092041 | (02) | WV |
805L940D | (02) | MD |