Provider Demographics
NPI:1548622517
Name:MAHAYNI, OMAR AREF (MD)
Entity type:Individual
Prefix:DR
First Name:OMAR
Middle Name:AREF
Last Name:MAHAYNI
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:P.O.BOX 42801
Mailing Address - Street 2:
Mailing Address - City:RIYADH
Mailing Address - State:RIYADH
Mailing Address - Zip Code:11551
Mailing Address - Country:SA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:DEMAS COMPANY
Practice Address - Street 2:42801
Practice Address - City:RIYADH
Practice Address - State:RIYADH
Practice Address - Zip Code:11551
Practice Address - Country:SA
Practice Address - Phone:96650-643-9626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program