Provider Demographics
NPI:1942201439
Name:GHRAOWI, MOHAMAD AYMAN (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:AYMAN
Last Name:GHRAOWI
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:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-2171
Mailing Address - Fax:956-362-3614
Practice Address - Street 1:640 S STATE ST FL 1
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-3530
Practice Address - Country:US
Practice Address - Phone:302-744-7994
Practice Address - Fax:302-744-7993
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0025012207RH0000X, 207RX0202X
GUM-2426207RH0003X
TXJ6958207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116131704Medicaid
TX116131704Medicaid
F91421Medicare UPIN