Individual
ANSERUDDIN MOHAMMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
119 WALNUT ST, WALNUT PLAZA, JOHNSTOWN, PA 15901-1625
(814) 534-1095
(814) 534-6145
Mailing address
1086 FRANKLIN ST, JOHNSTOWN, PA 15905-4305
(814) 410-8300
(814) 410-8331
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036165779
IL
2084P0800X
Psychiatry Physician
4301093935
MI
2084P0800X
Psychiatry Physician
U5298
TX
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
0101283480
VA
2084P0804X
Child & Adolescent Psychiatry Physician
036165779
IL
2084P0804X
Child & Adolescent Psychiatry Physician
4301093935
MI
2084P0804X
Child & Adolescent Psychiatry Physician
MD441808
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026258280001
—
PA
Enumeration date
07/08/2008
Last updated
05/13/2025
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