Provider Demographics
NPI:1427086719
Name:MOHAMED, KHALID (MD)
Entity type:Individual
Prefix:DR
First Name:KHALID
Middle Name:
Last Name:MOHAMED
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 1:8 HARVEY LN
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1386
Mailing Address - Country:US
Mailing Address - Phone:781-956-5052
Mailing Address - Fax:
Practice Address - Street 1:4 POST OFFICE SQ
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3207
Practice Address - Country:US
Practice Address - Phone:774-227-7055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51876207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A58476Medicare UPIN
MAA33275Medicare ID - Type Unspecified