Basic Information
| Provider Information | |||||||||
| NPI: | 1891772810 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FAHMY | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | NABIL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2359 FOREST HILL CIR | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 449038598 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195283278 | ||||||||
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| Practice Location | |||||||||
| Address1: | 215 WOOD ST | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 449032260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195222833 | ||||||||
| FaxNumber: | 4195241619 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/30/2005 | ||||||||
| LastUpdateDate: | 11/10/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 35-075597 | OH | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 000000130384 | 01 | OH | ANTHEM | OTHER | 020044563 | 01 | OH | RAILROAD MEDICARE | OTHER |