Healthcare Provider Details

I. General information

NPI: 1366443152
Provider Name (Legal Business Name): AMR Z HEGAZI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 01/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46B THOMAS JOHNSON DR SUITE 200
FREDERICK MD
21702-4300
US

IV. Provider business mailing address

46B THOMAS JOHNSON DR SUITE 200
FREDERICK MD
21702-4300
US

V. Phone/Fax

Practice location:
  • Phone: 301-695-6777
  • Fax: 301-695-4852
Mailing address:
  • Phone: 301-695-6777
  • Fax: 301-695-4852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberD44164
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: