Provider Demographics
NPI:1093564841
Name:MAHGOUB, HOSSAMELDIN
Entity type:Individual
Prefix:
First Name:HOSSAMELDIN
Middle Name:
Last Name:MAHGOUB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 DEAUVILLE DR APT 10
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2913
Mailing Address - Country:US
Mailing Address - Phone:412-742-9423
Mailing Address - Fax:
Practice Address - Street 1:360 DEAUVILLE DR APT 10
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2913
Practice Address - Country:US
Practice Address - Phone:412-742-9423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)