Provider Demographics
NPI:1720027246
Name:EL-GAMAL, HAZEM M (MD)
Entity Type:Individual
Prefix:MR
First Name:HAZEM
Middle Name:M
Last Name:EL-GAMAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2630 E 7TH STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204
Mailing Address - Country:US
Mailing Address - Phone:704-364-6110
Mailing Address - Fax:704-364-4245
Practice Address - Street 1:2630 E 7TH STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204
Practice Address - Country:US
Practice Address - Phone:704-364-6110
Practice Address - Fax:704-364-4245
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200500181207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH81793Medicare UPIN
NC2043131Medicare ID - Type Unspecified