Provider Demographics
NPI:1396797734
Name:AL-QUAIMI, MOHAMMAD (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:
Last Name:AL-QUAIMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-9614
Mailing Address - Country:US
Mailing Address - Phone:740-439-0733
Mailing Address - Fax:740-439-8996
Practice Address - Street 1:1325 CLARK ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-9614
Practice Address - Country:US
Practice Address - Phone:740-439-0733
Practice Address - Fax:740-439-8996
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH85137207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2509575Medicaid
OH2509575Medicaid
OHH30895Medicare UPIN