Provider Demographics
NPI:1144411653
Name:ALSAWAF, MHD ANAS (MBBS, MD)
Entity Type:Individual
Prefix:
First Name:MHD
Middle Name:ANAS
Last Name:ALSAWAF
Suffix:
Gender:M
Credentials:MBBS, MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9697 SAINT CATHERINES DR
Mailing Address - Street 2:STE 200
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-2118
Mailing Address - Country:US
Mailing Address - Phone:262-656-3590
Mailing Address - Fax:262-656-3591
Practice Address - Street 1:9697 SAINT CATHERINES DR
Practice Address - Street 2:STE 200
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-2118
Practice Address - Country:US
Practice Address - Phone:262-656-3590
Practice Address - Fax:262-656-3591
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2016-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ47631207X00000X, 207XS0114X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ154327Medicare PIN
AZ807215Medicaid