Individual
ADIL MOHYUDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 584-5601
(601) 984-6665
Mailing address
421 POPLAR BLVD, PEARL, MS 39208-3382
(779) 875-6139
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31793
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2020
Last updated
08/05/2024
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