Provider Demographics
NPI:1750389797
Name:BAYOUMI, AHMED M (MD)
Entity type:Individual
Prefix:DR
First Name:AHMED
Middle Name:M
Last Name:BAYOUMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 230
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NY
Mailing Address - Zip Code:14569-0230
Mailing Address - Country:US
Mailing Address - Phone:585-786-2290
Mailing Address - Fax:585-786-2853
Practice Address - Street 1:2261 STATE ROUTE 19 N
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569-9334
Practice Address - Country:US
Practice Address - Phone:585-786-2290
Practice Address - Fax:585-786-2853
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210742207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01861238Medicaid
NY01861238Medicaid
NYG77339Medicare UPIN
NYAA1293Medicare ID - Type UnspecifiedPRACTICE NUMBER