Provider Demographics
NPI:1518752237
Name:JAMA, MOHAMED OSMAN
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:OSMAN
Last Name:JAMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12547 WOLFORD PL
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-1242
Mailing Address - Country:US
Mailing Address - Phone:619-751-3993
Mailing Address - Fax:
Practice Address - Street 1:12547 WOLFORD PL
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-1242
Practice Address - Country:US
Practice Address - Phone:619-751-3993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN300098687343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)