Provider Demographics
NPI:1639428584
Name:HEGAZY, AHMED MOHAMMED (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:MOHAMMED
Last Name:HEGAZY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7857 HEDINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-1013
Mailing Address - Country:US
Mailing Address - Phone:419-824-3443
Mailing Address - Fax:
Practice Address - Street 1:625 ELMIRA RD
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4655
Practice Address - Country:US
Practice Address - Phone:707-451-0285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03132010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist