Provider Demographics
NPI:1992430508
Name:KANU, MOHAMED SHEIKA
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:SHEIKA
Last Name:KANU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13751 RUTHERGLEN CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4249
Mailing Address - Country:US
Mailing Address - Phone:704-605-5493
Mailing Address - Fax:
Practice Address - Street 1:13751 RUTHERGLEN CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-4249
Practice Address - Country:US
Practice Address - Phone:704-605-5493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)