Basic Information
| Provider Information | |||||||||
| NPI: | 1891969127 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ELSAGHIR | ||||||||
| FirstName: | HEND | ||||||||
| MiddleName: | EDRIS | ||||||||
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| Credential: | MBCHB | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4510 DORR ST # MS 840 | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436154040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5674201600 | ||||||||
| FaxNumber: | 5674201629 | ||||||||
| Practice Location | |||||||||
| Address1: | 3125 TRANSVERSE DR | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436148008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193833780 | ||||||||
| FaxNumber: | 4193833338 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2008 | ||||||||
| LastUpdateDate: | 08/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 35.133939 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207R00000X | 237698 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0308629 | 05 | OH | MEDICAID |