Healthcare Provider Details

I. General information

NPI: 1336061860
Provider Name (Legal Business Name): MOHAMED HAFIZ MOHAMED ELAMIN OMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

1878 E 90TH ST APT 213
CLEVELAND OH
44106-8001
US

V. Phone/Fax

Practice location:
  • Phone: 440-869-2650
  • Fax:
Mailing address:
  • Phone: 440-869-2650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57.259926
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: