Provider Demographics
NPI:1811174634
Name:TAHA, MOHAMED M (MD)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:M
Last Name:TAHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOHAMED
Other - Middle Name:M
Other - Last Name:ABDELGADIR TAHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 342
Mailing Address - Street 2:945 N 12TH ST AURORA SINAI MEDICAL CENTER
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53201-0342
Mailing Address - Country:US
Mailing Address - Phone:414-219-2000
Mailing Address - Fax:414-219-4539
Practice Address - Street 1:945 N 12TH ST
Practice Address - Street 2:AURORA SINAI MEDICAL CENTER
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-1305
Practice Address - Country:US
Practice Address - Phone:414-219-2000
Practice Address - Fax:414-219-4539
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50500207R00000X, 208M00000X
FLME110116207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist