=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194834754
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SIHAM M MAHGOUB MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/29/2006
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 400 SENTARA CIR STE 201B
-----------------------------------------------------
City | WILLIAMSBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23188-5716
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-345-4655
-----------------------------------------------------
Fax | 757-390-4892
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 400 SENTARA CIR STE 201B
-----------------------------------------------------
City | WILLIAMSBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23188-5716
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-345-4655
-----------------------------------------------------
Fax | 757-390-4892
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RI0200X
-----------------------------------------------------
Taxonomy Name | Infectious Disease Physician
-----------------------------------------------------
License Number | 0101239997
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 0101239997
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207RI0200X
-----------------------------------------------------
Taxonomy Name | Infectious Disease Physician
-----------------------------------------------------
License Number | 2189841
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------