Provider Demographics
NPI:1760437941
Name:FAHMY, NABIL W (MD)
Entity Type:Individual
Prefix:
First Name:NABIL
Middle Name:W
Last Name:FAHMY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-446-5131
Mailing Address - Fax:740-446-5486
Practice Address - Street 1:100 JACKSON PIKE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1560
Practice Address - Country:US
Practice Address - Phone:855-446-5937
Practice Address - Fax:740-446-5486
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-5812207R00000X
WV18076207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0077484000Medicaid
WVP00806990OtherWV RAILROAD MEDICARE
OH310917085063OtherCARESOURCE MEDICAID
000000007576OtherANTHEM BCBS
001714076OtherMOUNTAIN STATE BCBS
110095042OtherRR MEDICARE
OH0991155OtherMOLINA MEDICAID
OH000000181887OtherUNISON MEDICAID
OH0991155Medicaid
OH310917085063OtherCARESOURCE MEDICAID
OH0991155Medicaid
OH0769644Medicare PIN