Basic Information
| Provider Information | |||||||||
| NPI: | 1225655780 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAMOOD | ||||||||
| FirstName: | MOHAMED | ||||||||
| MiddleName: | ALLIE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5450 FORT ST | ||||||||
| Address2: | |||||||||
| City: | TRENTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481834601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346713297 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5450 FORT ST | ||||||||
| Address2: | |||||||||
| City: | TRENTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481834601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346713297 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2020 | ||||||||
| LastUpdateDate: | 06/23/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 207P00000X | 4351049802 | MI | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.