Healthcare Provider Details

I. General information

NPI: 1831038710
Provider Name (Legal Business Name): MAHMOUD MOHAMED HAMDY MAHMOUD GOMAA MBBCH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MAHMOUD GOMAA MBBCH

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 DIXMYTH AVE
CINCINNATI OH
45220-2489
US

IV. Provider business mailing address

473 W 12TH AVE STE 105 SUITE 105
COLUMBUS OH
43210-1252
US

V. Phone/Fax

Practice location:
  • Phone: 513-862-1800
  • Fax: 513-751-8638
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: