Provider Demographics
NPI:1679556583
Name:MOHAMMED M MOHIUDDIN MD PA
Entity type:Organization
Organization Name:MOHAMMED M MOHIUDDIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:MUDDASSIR
Authorized Official - Last Name:MOHIUDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-694-8080
Mailing Address - Street 1:801 TOLL HOUSE AVE
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4564
Mailing Address - Country:US
Mailing Address - Phone:301-694-8080
Mailing Address - Fax:301-694-8089
Practice Address - Street 1:801 TOLL HOUSE AVE
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4564
Practice Address - Country:US
Practice Address - Phone:301-694-8080
Practice Address - Fax:301-694-8089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty