Provider Demographics
NPI:1205862505
Name:NASHAWI, MHD TAREK (MD)
Entity Type:Individual
Prefix:
First Name:MHD TAREK
Middle Name:
Last Name:NASHAWI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOHAMMAD
Other - Middle Name:TAREK
Other - Last Name:NASHAWI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1796 PROVINCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6994
Mailing Address - Country:US
Mailing Address - Phone:313-550-3982
Mailing Address - Fax:541-744-6150
Practice Address - Street 1:1255 HILYARD ST FL 4
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3718
Practice Address - Country:US
Practice Address - Phone:541-852-3259
Practice Address - Fax:458-209-5013
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD26475207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR278326Medicaid
ORP00400672OtherRAIL ROAD MEDICARE
AZ221898Medicaid
OR885371001OtherBCBS
OR278326Medicaid
AZ116695Medicare PIN