Provider Demographics
NPI:1659486470
Name:EL-MEANAWY, ASHRAF (MD, PHD, MS)
Entity Type:Individual
Prefix:DR
First Name:ASHRAF
Middle Name:
Last Name:EL-MEANAWY
Suffix:
Gender:M
Credentials:MD, PHD, MS
Other - Prefix:DR
Other - First Name:M.
Other - Middle Name:ASHRAF
Other - Last Name:EL-MEANAWY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD, MS
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:DIVISION OF NEPHROLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-3100
Mailing Address - Fax:414-805-9059
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:DIVISION OF NEPHROLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-3100
Practice Address - Fax:414-805-9059
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070815207R00000X
WI50834207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0282528Medicaid
WI1659486470Medicaid
OHEL7272591Medicare ID - Type Unspecified
WI1069 73-601Medicare PIN
OH0282528Medicaid