Individual
MOHAMED MAHMOUD ALI AHMED FARRAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(717) 531-8521
Mailing address
500 UNIVERSITY DR, HERSHEY, PA 17033-2391
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD472206
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103881321
—
PA
01
—
1114389970
NPI
—
01
—
15089158
CAQH
—
Enumeration date
03/22/2016
Last updated
01/07/2025
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