Basic Information
| Provider Information | |||||||||
| NPI: | 1962484261 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOHAMED | ||||||||
| FirstName: | ASIF | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3421 BENSON AVE | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212271056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103681370 | ||||||||
| FaxNumber: | 4103681382 | ||||||||
| Practice Location | |||||||||
| Address1: | 3421 BENSON AVE | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103681370 | ||||||||
| FaxNumber: | 4103681382 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2005 | ||||||||
| LastUpdateDate: | 12/31/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | D0061387 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | 7015391 | 01 | CIGNA | OTHER | 64114701 | 01 | CARE FIRST | OTHER | J69000002 | 01 | BLUE CHOICE | OTHER | 7322536 | 01 | AETNA PPO | OTHER | 3132403 | 01 | MAMSI | OTHER | 3502085 | 01 | AETNA HMO | OTHER | 522442528 | 01 | UNITED H CARE | OTHER |