Provider Demographics
NPI:1194944694
Name:SHITTU, MUHAMMED (MHW2)
Entity type:Individual
Prefix:
First Name:MUHAMMED
Middle Name:
Last Name:SHITTU
Suffix:
Gender:M
Credentials:MHW2
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 CHANDLER CT
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:CA
Mailing Address - Zip Code:95334-9110
Mailing Address - Country:US
Mailing Address - Phone:209-394-8204
Mailing Address - Fax:
Practice Address - Street 1:300 E 13TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340
Practice Address - Country:US
Practice Address - Phone:209-381-6879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator