1871677997 NPI number — DR. TAMER OMAR EL-MAHDY MD

Table of content: DR. TAMER OMAR EL-MAHDY MD (NPI 1871677997)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871677997 NPI number — DR. TAMER OMAR EL-MAHDY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EL-MAHDY
Provider First Name:
TAMER
Provider Middle Name:
OMAR
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RASHEED EL-MAHDY
Provider Other First Name:
TAMER
Provider Other Middle Name:
OMAR
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1871677997
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/06/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16 HOSPITAL DR
Provider Second Line Business Mailing Address:
STE D
Provider Business Mailing Address City Name:
YORK
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
03909-1041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-239-4404
Provider Business Mailing Address Fax Number:
515-239-4721

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1215 DUFF AVE.
Provider Second Line Business Practice Location Address:
MCFARLAND CLINIC, PC
Provider Business Practice Location Address City Name:
AMES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50010-3014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-239-4404
Provider Business Practice Location Address Fax Number:
515-239-4721
Provider Enumeration Date:
10/25/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  MA07191400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: MA07191400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: 39539 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1857182 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8606901 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9920005 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".