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Individual

DR. MOHAMMAD N AL SHROOF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2054 WATSON BLVD, WARNER ROBINS, GA 31093-3634
(478) 918-0770
(478) 918-0771
Mailing address
2054 WATSON BLVD, WARNER ROBINS, GA 31093-3634
(478) 918-0770
(478) 918-0771

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
045158
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000807155AB
GA
05
000807155AC
GA
05
000807155I
GA
05
000807155R
GA
01
110237442
MEDICARE RAILROAD#
GA
01
1578519286
NPI
01
468916
WELLCARE
GA
01
511I110627
MEDICARE PTAN
01
614236400
DEPT OF LABOR
GA
01
867194728A
GBHC
GA
Enumeration date
05/25/2006
Last updated
05/10/2024
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