Basic Information
Provider Information
NPI: 1457707234
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAMDANI
FirstName: MOHAMMED
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D., PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 170 MANNING DR
Address2: CB# 7070, PHYSICIAN'S OFFICE BUILDING, ROOM G-190
City: CHAPEL HILL
State: NC
PostalCode: 275144221
CountryCode: US
TelephoneNumber: 2019234843
FaxNumber:  
Practice Location
Address1: 170 MANNING DR
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275144221
CountryCode: US
TelephoneNumber: 9199663342
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/10/2016
LastUpdateDate: 05/10/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Y00000X219179NCY Allopathic & Osteopathic PhysiciansOtolaryngology 

No ID Information.


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