Healthcare Provider Details

I. General information

NPI: 1932550175
Provider Name (Legal Business Name): MAHMOUD ABDELWAHAB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2016
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 DIXMYTH AVE STE 867.2
CINCINNATI OH
45220-2475
US

IV. Provider business mailing address

4685 FOREST AVE
CINCINNATI OH
45212-3397
US

V. Phone/Fax

Practice location:
  • Phone: 513-862-6200
  • Fax: 513-862-4358
Mailing address:
  • Phone: 513-246-1964
  • Fax: 513-852-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35.155476
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberBP10056531
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberC5592
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: