| Doctor Name: | MR. MOHAMMED FUAD |
| NPI Number: | 1730160938 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 12/31/2006 |
| Business Practice Address: | 66 Mds (afmc) 90 Vandenberg Dr. Bldg. 1900 Hanscom Afb, MA - 01731 |
| Business Phone Number: | 7812256789 |
| Business Fax Number: | |
| Mailing Address: | 66 Mds (afmc), 90 Vandenberg Dr. Bldg. 1900 HANSCOM AFB |
| State: | MA |
| Postal Code: | 01731 |
| Phone Number: | 7812256789 |
| Fax Number: | |
| NPI Enumeration Date: | 11/07/2005 |
| NPI Last Update Date: | 01/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 12/31/2006 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |