Provider Demographics
NPI:1457606261
Name:ABDELRAHMAN, MOHAMED MAHFOUZ AMIN (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:MAHFOUZ AMIN
Last Name:ABDELRAHMAN
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 1:2929 E CAMELBACK RD STE 116
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4425
Mailing Address - Country:US
Mailing Address - Phone:602-698-5820
Mailing Address - Fax:
Practice Address - Street 1:2929 E CAMELBACK RD STE 116
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4425
Practice Address - Country:US
Practice Address - Phone:602-698-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293926207R00000X
AZ60036207R00000X, 207RC0000X, 207RC0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology