Individual
DR. TAN LUCIEN HASSAN MOHAMMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD # 100374, GAINESVILLE, FL 32610-0374
(352) 265-0291
(352) 265-0279
Mailing address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 515-5811
(206) 515-5886
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
35084772
OH
2085R0202X
Diagnostic Radiology Physician
MD2022-0580
NM
2085R0202X
Diagnostic Radiology Physician
Primary
ME120580
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012305300
—
FL
01
—
0299743
LABOR & INDUSTRY
WA
05
—
1063476356
—
WA
05
—
2517208
—
OH
01
—
MD00123
AK DSHS
WA
01
—
P01121104
RAILROAD MEDICARE
WA
Enumeration date
04/13/2006
Last updated
08/16/2024
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