Provider Demographics
NPI:1427334838
Name:HAMZA, MOHAMED ALI (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:ALI
Last Name:HAMZA
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 1:5350 FRANTZ RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4259
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 THOMAS LN
Practice Address - Street 2:SUITE 2E
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3902
Practice Address - Country:US
Practice Address - Phone:614-566-9777
Practice Address - Fax:614-566-5611
Is Sole Proprietor?:No
Enumeration Date:2011-10-30
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4429142084N0400X
OH35.1208922084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0082784Medicaid
OHH194800Medicare PIN