Provider Demographics
NPI:1669673216
Name:ELGAMAL, MOHAMED HOSNY (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:HOSNY
Last Name:ELGAMAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1040 SIERRA DR STE 400
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7241
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:9800 VALPARAISO DR
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-4040
Practice Address - Country:US
Practice Address - Phone:219-836-5800
Practice Address - Fax:219-836-7593
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01073821A208600000X
METD121120208600000X
PAMD447654208600000X
MI4301089619208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201241180Medicaid