Provider Demographics
NPI:1659950129
Name:MOHAMED, MOHAMED SABER AMIN ELYAMNY (MD)
Entity type:Individual
Prefix:MR
First Name:MOHAMED
Middle Name:SABER AMIN ELYAMNY
Last Name:MOHAMED
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1290 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:860-972-9033
Mailing Address - Fax:860-972-7040
Practice Address - Street 1:80 SEYMOUR ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06102-8000
Practice Address - Country:US
Practice Address - Phone:860-972-0549
Practice Address - Fax:605-455-2218
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-03
Last Update Date:2024-07-08
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Provider Licenses
StateLicense IDTaxonomies
CT77067207R00000X
MO2021026033390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine