Individual
OMAR A MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
450 N 33RD ST APT 2, MILWAUKEE, WI 53208-3854
(414) 885-8127
(414) 448-6940
Mailing address
450 N 33RD ST APT 2, MILWAUKEE, WI 53208-3854
(414) 885-8127
(414) 448-6940
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
M53064194001-04
WI
Other
Enumeration date
01/12/2019
Last updated
01/12/2019
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