Individual
DR. SAMAH O MOHIUDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1340 WASHINGTON ST, WATERTOWN, NY 13601-4541
(315) 782-9003
(315) 782-9010
Mailing address
445 FACTORY ST, WATERTOWN, NY 13601-2729
(315) 782-4207
(315) 782-8699
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
266512
NY
2084N0400X
Neurology Physician
266512-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03283901
—
NY
01
—
PENDING
MEDICARE
FL
01
—
PENDING
COMMERCIAL
NY
Enumeration date
08/31/2010
Last updated
12/14/2021
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