Provider Demographics
NPI:1932690526
Name:GHANDOUR, MOHAMEDANWAR MOAWIA NOURELDIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMEDANWAR
Middle Name:MOAWIA NOURELDIN
Last Name:GHANDOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7710 MERCY RD STE 426
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2323
Mailing Address - Country:US
Mailing Address - Phone:402-343-8650
Mailing Address - Fax:402-343-8545
Practice Address - Street 1:7710 MERCY RD STE 426
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2323
Practice Address - Country:US
Practice Address - Phone:402-343-8650
Practice Address - Fax:402-343-8545
Is Sole Proprietor?:No
Enumeration Date:2018-05-20
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-52433207RN0300X
NE36103207RN0300X
MI4301504536207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology