Individual
DR. WAZIM MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4201 SAINT ANTOINE ST, STE 8A & 8B, DETROIT, MI 48201-2153
(313) 745-4275
(313) 745-4468
Mailing address
1560 E MAPLE RD, SUITE 400-CREDENTIALING DEPT, TROY, MI 48083-1138
(313) 745-4275
(313) 745-4468
Taxonomy
Speciality
Code
Description
License number
State
2084A2900X
Neurocritical Care Physician
Primary
4301092204
MI
2084N0400X
Neurology Physician
4301092204
MI
2084V0102X
Vascular Neurology Physician
4301092204
MI
Other
Enumeration date
06/30/2009
Last updated
02/25/2022
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