Provider Demographics
NPI:1134479629
Name:ABDELGHANY, MAHMOUD SAMY MOHAMED (MD)
Entity Type:Individual
Prefix:
First Name:MAHMOUD
Middle Name:SAMY MOHAMED
Last Name:ABDELGHANY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 MEDICAL CENTER DR STE 410
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1273
Mailing Address - Country:US
Mailing Address - Phone:413-748-7076
Mailing Address - Fax:413-732-0225
Practice Address - Street 1:300 STAFFORD ST STE 101
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3581
Practice Address - Country:US
Practice Address - Phone:413-732-1928
Practice Address - Fax:413-732-0225
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT201936207R00000X
MA278177207RI0011X, 207RC0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program