Healthcare Provider Details

I. General information

NPI: 1255587358
Provider Name (Legal Business Name): MOHAMMED ABDELGHANI GERAIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2851 S AVENUE B BLDG 25
YUMA AZ
85364-7726
US

IV. Provider business mailing address

2400 S AVENUE A
YUMA AZ
85364-7170
US

V. Phone/Fax

Practice location:
  • Phone: 928-336-2110
  • Fax: 928-336-2137
Mailing address:
  • Phone: 928-344-2000
  • Fax: 928-336-1395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number40344
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number40344
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: