Provider Demographics
NPI:1568781144
Name:AHMAD SABRY, MOHAMMAD HAZEM IBRAHIM (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD HAZEM
Middle Name:IBRAHIM
Last Name:AHMAD SABRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 S MAGNOLIA ST
Mailing Address - Street 2:MCCOMB NOPAIN CLINIC
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39648-4233
Mailing Address - Country:US
Mailing Address - Phone:601-250-1055
Mailing Address - Fax:601-250-1057
Practice Address - Street 1:215 S MAGNOLIA ST
Practice Address - Street 2:MCCOMB NOPAIN CLINIC
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-4233
Practice Address - Country:US
Practice Address - Phone:601-250-1055
Practice Address - Fax:601-250-1057
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-22
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39484207L00000X
PAMD439902207L00000X
MS19115207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology