Healthcare Provider Details

I. General information

NPI: 1881137313
Provider Name (Legal Business Name): MOHAMED ELTEMAMY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2016
Last Update Date: 09/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

27060 CEDAR RD APT 504
BEACHWOOD OH
44122-1129
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-2200
  • Fax: 216-444-9375
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number35.134624
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: