Provider Information for 1386159499
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WILLIE JAMELE MUHAMMAD
Sex: Male
NPI: 1386159499
Last Updated: 2024-01-03
Certification Date: 2024-01-03
Certification Date: 2024-01-03
Details
| Name | Value | ||||||||||||||||||||||||
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| NPI | 1386159499 | ||||||||||||||||||||||||
| Enumeration Date | 2017-12-12 | ||||||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||||||||||
| Status | Active | ||||||||||||||||||||||||
| Mailing Address | 5571 W UNIVERSITY AVE FRESNO, CA 93722-8738 United States Phone: 559-270-7037 | Fax: | ||||||||||||||||||||||||
| Primary Practice Address | 5571 W UNIVERSITY AVE FRESNO, CA 93722-8738 United States Phone: 559-270-7037 | Fax: | ||||||||||||||||||||||||
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