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Amal Othman Mohammad

Internal Medicine

Allopathic & Osteopathic Physicians

3601 W 13 Mile Rd, Royal Oak, MI 48073-6712

PECOS Enrollment

This provider is enrolled in PECOS as AMAL MOHAMMAD.

Based on the most recent information from CMS, provider Amal Othman Mohammad is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 9:21 AM.

Profile Details

Provider ID
1144492463
Provider Type
Individual
Full Name
Mohammad, Amal Othman
Title
Dr.
Credential
MB, BS.

Gender
Female
Sole Proprietor
No
Enumeration Date
3/26/2008
Last Updated
5/21/2012

Contact Information

Practice Location

3601 W 13 Mile Rd, Royal Oak, MI 48073-6712

(248) 691-8646

Unlisted Fax

Mailing Location

5440 Wessex Ct, Apt 101, Dearborn, MI 48126-4267

(216) 502-0027

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License N8225 Texas
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License 57.013145 Ohio

Amal Othman Mohammad

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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Elshiekh, Eltayeb H

Niazi, Summer

Fecko, Alice Marie

Majeed, Muhammad Ibrahim

Mumtaz, Samar

Rempakos, Athanasios

Aref, Ahmed Mohamed Ali

Madanat, Luai Fadi

Naeem, Ehsun