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General NPI Number Information
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NPI Number | 1154165645
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Entity Type | Organization
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Legal Business Name | PIMA FOOT AND ANKLE SURGERY
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Dates
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Enumeration Date | 06/20/2024
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4739 N 1ST AVE
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City | TUCSON
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State | AZ
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Zip | 85718-5610
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Country | US
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Telephone | 520-614-6617
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Fax |
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Provider Business Mailing Address
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Address Line | 4739 N 1ST AVE
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City | TUCSON
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State | AZ
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Zip | 85718-5610
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Country | US
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Telephone | 520-614-6617
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MOHANAD ELTAHIR
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Credential | DPM
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Telephone | 703-501-0283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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