Provider Demographics
NPI:1790068369
Name:DARWISH, MOHAMED HAMDY
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:HAMDY
Last Name:DARWISH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5912 HOLLOW WOOD CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-3771
Mailing Address - Country:US
Mailing Address - Phone:804-503-0990
Mailing Address - Fax:336-983-5091
Practice Address - Street 1:600 S MAIN ST.
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021
Practice Address - Country:US
Practice Address - Phone:336-983-0266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20291183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist