Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.137514 | OH |
Y | 2080P0210X | Pediatric Nephrologist | 35.137514 | OH |
NPI | 1225477789 |
---|---|
Provider Name | Tahagod H Mohamed |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2013 |
Last Update Date | 22/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0369267 | (05) | OH |
H761780 | CGS MEDICARE (01) | OH |