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NPI Code Detail

MEDICARE: DR. MAHMOUD ELBADRAWY MD

MEDICARE: DR. MAHMOUD ELBADRAWY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician036177234IL
2207R00000XInternal Medicine Physician84938-20WI

General Provider Information

NPI Number : 1750024121
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAHMOUD ELBADRAWY MD
Provider Business Mailing Address
First Line : 420 E DIVISION ST
Second Line :
City : FOND DU LAC
State : WI
Zip : 54935-4560
Country : US
Telephone Number : 920-926-8200
Fax Number :
Provider Business Practice Location Address
First Line : 420 E DIVISION ST
Second Line :
City : FOND DU LAC
State : WI
Zip : 54935-4560
Country : US
Telephone Number : 920-926-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2022
Last Update Date : 12/11/2025

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