Provider Demographics
NPI:1275351777
Name:YOUSUF, MOHAMMED MATEEN
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:MATEEN
Last Name:YOUSUF
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 1:134 BOWER LN
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-1749
Mailing Address - Country:US
Mailing Address - Phone:443-417-5749
Mailing Address - Fax:
Practice Address - Street 1:134 BOWER LN
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-1749
Practice Address - Country:US
Practice Address - Phone:443-417-5749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15489183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty