Provider Demographics
NPI:1366443152
Name:HEGAZI, AMR Z (MD)
Entity Type:Individual
Prefix:DR
First Name:AMR
Middle Name:Z
Last Name:HEGAZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:46B THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4300
Mailing Address - Country:US
Mailing Address - Phone:301-695-6777
Mailing Address - Fax:301-695-4852
Practice Address - Street 1:46B THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 200
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4300
Practice Address - Country:US
Practice Address - Phone:301-695-6777
Practice Address - Fax:301-695-4852
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD44164207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0081294000OtherWV. PROVIDER NPI
MD1366443152OtherNPI
MD452149OtherMAMSI
WV9294621OtherWV MEDICARE
MD112080800Medicaid
MD3601046OtherUNITED HEALTHCARE
MD5388078OtherAETNA
MD01960002OtherCAREFIRST FEDERAL
MD54749504OtherCAREFIRST
WV3810012215Medicaid
MD522074387OtherTAX ID
WVHE0842581Medicare ID - Type Unspecified
MD452149OtherMAMSI
MD1366443152OtherNPI
MD522074387OtherTAX ID