Individual
MOHAMMED OMAR AHMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
401 W POPLAR ST, WALLA WALLA, WA 99362
(509) 897-3320
Mailing address
PO BOX 32, LIBERTY LAKE, WA 99019-0032
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60797874
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2100363
—
WA
Enumeration date
07/22/2015
Last updated
09/28/2018
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