Provider Demographics
NPI:1548252752
Name:MEGAHY, MOHAMED SALEH (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:SALEH
Last Name:MEGAHY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 747
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62222-0747
Mailing Address - Country:US
Mailing Address - Phone:618-288-2800
Mailing Address - Fax:618-288-2822
Practice Address - Street 1:1201 E UNION AVE
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:IL
Practice Address - Zip Code:62056-1700
Practice Address - Country:US
Practice Address - Phone:217-324-1100
Practice Address - Fax:217-324-1103
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036066170174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036066170Medicaid