Individual
MEDHAT FAHMEY SIDAROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2402 CAMDEN ST SW, SUITE B 500, WILSON, NC 27893-8608
(252) 291-8600
(252) 291-6914
Mailing address
PO BOX 3544, WILSON, NC 27895-3544
(252) 291-8600
(252) 291-6914
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9600733
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1389Y
BLUE CROSS
NC
05
—
5900812
—
NC
Enumeration date
02/17/2006
Last updated
09/25/2023
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