Provider Demographics
NPI:1285628347
Name:HAMID, MOHAMED A (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:A
Last Name:HAMID
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29001 CEDAR ROAD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4062
Mailing Address - Country:US
Mailing Address - Phone:440-684-9970
Mailing Address - Fax:440-684-9971
Practice Address - Street 1:29001 CEDAR ROAD
Practice Address - Street 2:SUITE 203
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-4062
Practice Address - Country:US
Practice Address - Phone:440-684-9970
Practice Address - Fax:440-684-9971
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-069345231H00000X
OH359069345207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0211201Medicaid
OH000000121472OtherANTHEM
OH0211201Medicaid
OHHA0792243Medicare ID - Type Unspecified
OH000000121472OtherANTHEM