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Individual

ATM GOUSE MOHIUDDIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8900 170TH ST, JAMAICA, NY 11432-5341
(347) 249-0768
(509) 357-0622
Mailing address
8900 170TH ST, JAMAICA, NY 11432-5341
(347) 249-0768
(509) 357-0622

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
0101280452
VA
208D00000X
General Practice Physician
Primary
85700
GA

Other

Enumeration date
07/28/2020
Last updated
08/24/2025
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