Provider Demographics
NPI:1538257076
Name:EL GAMMAL, AHMED (MD)
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:EL GAMMAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3200 MACCORKLE AVE SE
Mailing Address - Street 2:STE B16
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1227
Mailing Address - Country:US
Mailing Address - Phone:606-598-5104
Mailing Address - Fax:606-598-0983
Practice Address - Street 1:509 MEMORIAL DRIVE
Practice Address - Street 2:SUITE 2
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-6195
Practice Address - Country:US
Practice Address - Phone:606-598-8813
Practice Address - Fax:606-598-0983
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV26248208M00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100025640Medicaid
3321170Medicare PIN