Provider Demographics
NPI:1760202832
Name:MOHAMED, HIRAD
Entity type:Individual
Prefix:
First Name:HIRAD
Middle Name:
Last Name:MOHAMED
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 1:3080 OLD HIGHWAY 8 APT 416
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-5567
Mailing Address - Country:US
Mailing Address - Phone:612-814-9130
Mailing Address - Fax:
Practice Address - Street 1:3080 OLD HIGHWAY 8 APT 416
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-5567
Practice Address - Country:US
Practice Address - Phone:612-814-9130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)