Provider Demographics
NPI:1336838077
Name:ELSAIDI, AHMED MAHMOUD EMAD AHMED (MBBCH)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:MAHMOUD EMAD AHMED
Last Name:ELSAIDI
Suffix:
Gender:M
Credentials:MBBCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2032 WEST ASTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-2606
Mailing Address - Country:US
Mailing Address - Phone:623-986-3810
Mailing Address - Fax:
Practice Address - Street 1:6200 N LA CHOLLA BLVD.
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741
Practice Address - Country:US
Practice Address - Phone:623-986-3810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program