Provider Demographics
NPI:1699232041
Name:ELHEFNAWI, EHAB KHAMIS (MD)
Entity type:Individual
Prefix:
First Name:EHAB
Middle Name:KHAMIS
Last Name:ELHEFNAWI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EHAB
Other - Middle Name:KHAMIS ELSAID AHMED
Other - Last Name:ELHIFNAWY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:NORTHERN LIGHT EASTERN MAINE MEDICAL CENTER
Mailing Address - Street 2:43 WHITING HILL ROAD, STE. 300
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1002
Mailing Address - Country:US
Mailing Address - Phone:207-973-5035
Mailing Address - Fax:207-973-5042
Practice Address - Street 1:12222 MERIT DR STE 600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-3294
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD16212207L00000X
TXT5106207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology