Provider Demographics
NPI:1144299785
Name:MOHIUDDIN, MUHAMMED SALMAN (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMED
Middle Name:SALMAN
Last Name:MOHIUDDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3652 W ALBION AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-4006
Mailing Address - Country:US
Mailing Address - Phone:847-674-2332
Mailing Address - Fax:
Practice Address - Street 1:3652 W ALBION AVE
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-4006
Practice Address - Country:US
Practice Address - Phone:847-674-2332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301079049207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MM079049OtherBCBS
MI104875694Medicaid
MI4346185Medicaid
MIN27530013Medicare ID - Type Unspecified
MI4346185Medicaid
MM079049OtherBCBS
MIMI1609073Medicare PIN