Provider Demographics
NPI:1174183982
Name:ALSHAMI, MOHAMMAD ASS'AD (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:ASS'AD
Last Name:ALSHAMI
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 1:202 10TH ST SE STE 225, PCI MEDICAL PAVILION
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403
Mailing Address - Country:US
Mailing Address - Phone:319-371-0338
Mailing Address - Fax:
Practice Address - Street 1:202 10TH ST SE STE 225, PCI MEDICAL PAVILION
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403
Practice Address - Country:US
Practice Address - Phone:718-226-8855
Practice Address - Fax:718-226-1347
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IAMD-53970207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program