Provider Demographics
NPI:1508915455
Name:MUHAMMAD, AKILI (MD)
Entity type:Individual
Prefix:DR
First Name:AKILI
Middle Name:
Last Name:MUHAMMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:AKILI
Other - Middle Name:H
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3610 BUTTONWOOD DR STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-3721
Mailing Address - Country:US
Mailing Address - Phone:314-901-4135
Mailing Address - Fax:
Practice Address - Street 1:3610 BUTTONWOOD DR STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-3721
Practice Address - Country:US
Practice Address - Phone:314-901-4135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023040767207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147779603Medicaid
TX147779603Medicaid
TX8F1665Medicare PIN