Provider Demographics
NPI:1760552699
Name:DESOUKI, MOHAMED MOKHTAR EL SAYED (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:MOKHTAR EL SAYED
Last Name:DESOUKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOHAMED
Other - Middle Name:M
Other - Last Name:DESOUKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3601 TVC
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0001
Mailing Address - Country:US
Mailing Address - Phone:615-322-3000
Mailing Address - Fax:
Practice Address - Street 1:ELM & CARLTON STREETS
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263
Practice Address - Country:US
Practice Address - Phone:716-845-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 114641207ZP0102X
SCMD 28931207ZP0102X
TNMD48519207ZP0102X
NY301380207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology