Provider Demographics
NPI:1386388650
Name:MOHAMMED, ELMKDAD (MBBS)
Entity type:Individual
Prefix:
First Name:ELMKDAD
Middle Name:
Last Name:MOHAMMED
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6650 CORPORATE CENTER PKWY APT 209
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-8737
Mailing Address - Country:US
Mailing Address - Phone:773-957-2382
Mailing Address - Fax:
Practice Address - Street 1:6650 CORPORATE CENTER PKWY APT 209
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8737
Practice Address - Country:US
Practice Address - Phone:773-957-2382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-23
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program