Provider Demographics
NPI:1720960586
Name:MOHAMAD, MOHAMAD ABDELRAUF (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMAD
Middle Name:ABDELRAUF
Last Name:MOHAMAD
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 1:63 CAMDEN LN UNIT 301
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-7211
Mailing Address - Country:US
Mailing Address - Phone:570-316-5337
Mailing Address - Fax:
Practice Address - Street 1:63 CAMDEN LN UNIT 301
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-7211
Practice Address - Country:US
Practice Address - Phone:570-316-5337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PALT001083207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology