Individual
FAWZI TAWFIC MOHAMMAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1348 WALTON WAY STE 5700, AUGUSTA, GA 30901-5110
(706) 774-7022
(706) 774-7023
Mailing address
PO BOX 1524, AUGUSTA, GA 30903-1524
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
067687
GA
2085R0202X
Diagnostic Radiology Physician
N1778
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003125609C
—
GA
01
—
P01060231
RAILROAD MEDICARE
GA
Enumeration date
04/17/2009
Last updated
04/08/2021
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