Provider Demographics
NPI:1427495274
Name:NAYEEMUDDIN, MOHAMMED (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:
Last Name:NAYEEMUDDIN
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 1:16259 SYLVESTER RD SW STE 404
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-3059
Mailing Address - Country:US
Mailing Address - Phone:206-241-1818
Mailing Address - Fax:253-539-6025
Practice Address - Street 1:16259 SYLVESTER RD SW STE 404
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-3059
Practice Address - Country:US
Practice Address - Phone:206-241-1818
Practice Address - Fax:253-539-6025
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAM60941810207RP1001X
WAMD60941810207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2141075Medicaid