Provider Demographics
NPI:1871515767
Name:ELGAHMI, MOHAMED A (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:A
Last Name:ELGAHMI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:337 STEWART RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-4393
Mailing Address - Country:US
Mailing Address - Phone:734-243-3200
Mailing Address - Fax:734-243-3202
Practice Address - Street 1:337 STEWART RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-4393
Practice Address - Country:US
Practice Address - Phone:734-243-3200
Practice Address - Fax:734-243-3202
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2013-09-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301081608207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5188151-10Medicaid