Provider Demographics
NPI:1104062108
Name:NASER, MOHAMED H
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:H
Last Name:NASER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MOHAMED
Other - Middle Name:A
Other - Last Name:BABIKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3708 W CAMELBACK RD APT 3
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85019-2625
Mailing Address - Country:US
Mailing Address - Phone:602-748-8545
Mailing Address - Fax:
Practice Address - Street 1:10000 N 31ST AVE STE C206
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-9620
Practice Address - Country:US
Practice Address - Phone:602-903-8922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-21
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343900000X
AZ318090343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)