Provider Demographics
NPI:1679565527
Name:ELNOUR, MOHAMED F (MD, FASN)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:F
Last Name:ELNOUR
Suffix:
Gender:M
Credentials:MD, FASN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 N 21ST ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-2223
Mailing Address - Country:US
Mailing Address - Phone:717-737-3377
Mailing Address - Fax:717-737-3387
Practice Address - Street 1:425 N 21ST ST
Practice Address - Street 2:SUITE 204
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2223
Practice Address - Country:US
Practice Address - Phone:717-737-3377
Practice Address - Fax:717-737-3387
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045806L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA025516PZ7Medicare ID - Type Unspecified
PAB69402Medicare UPIN