Provider Demographics
NPI:1124479811
Name:ELNAIR, RADOWAN ALI MAHGOUB (MD)
Entity type:Individual
Prefix:
First Name:RADOWAN
Middle Name:ALI MAHGOUB
Last Name:ELNAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905-0002
Mailing Address - Country:US
Mailing Address - Phone:507-284-2511
Mailing Address - Fax:507-266-4972
Practice Address - Street 1:1400 WEST 22ND STREET
Practice Address - Street 2:USD-SSOM-INTERNAL MEDICINE RESIDENCY
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105
Practice Address - Country:US
Practice Address - Phone:605-357-1557
Practice Address - Fax:605-357-1365
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN71100207RH0003X, 207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology