Provider Demographics
NPI:1568261873
Name:AMRO, MOHAMMAD
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:
Last Name:AMRO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 VIRGIL DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-3412
Mailing Address - Country:US
Mailing Address - Phone:317-437-0165
Mailing Address - Fax:
Practice Address - Street 1:58 VIRGIL DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-3412
Practice Address - Country:US
Practice Address - Phone:317-437-0165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN3460321470172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver