Provider Demographics
NPI:1003379215
Name:RAMADAN, MOHAMED EHAB RAMADAN MOHAMED (MBBCH, MSC, PHD)
Entity type:Individual
Prefix:DR
First Name:MOHAMED EHAB
Middle Name:RAMADAN MOHAMED
Last Name:RAMADAN
Suffix:
Gender:M
Credentials:MBBCH, MSC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 MAIN ST STE 1300
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-6107
Mailing Address - Country:US
Mailing Address - Phone:917-900-5056
Mailing Address - Fax:
Practice Address - Street 1:1350 MAIN ST STE 1300
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-6107
Practice Address - Country:US
Practice Address - Phone:917-900-5056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-14
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1018162207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology