Provider Demographics
NPI:1831733609
Name:MOHAMMED, AHMED (DOM)
Entity type:Individual
Prefix:DR
First Name:AHMED
Middle Name:
Last Name:MOHAMMED
Suffix:
Gender:M
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 CARLISLE DR STE 114
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4830
Mailing Address - Country:US
Mailing Address - Phone:703-834-9754
Mailing Address - Fax:
Practice Address - Street 1:481 CARLISLE DR STE 114
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4830
Practice Address - Country:US
Practice Address - Phone:703-834-9754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000901171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty