Provider Demographics
NPI:1760680946
Name:ELMAHI, MUTAZ ABDURAHMAN GORASHI (MD)
Entity type:Individual
Prefix:
First Name:MUTAZ
Middle Name:ABDURAHMAN GORASHI
Last Name:ELMAHI
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 1:1200 N ELM ST
Mailing Address - Street 2:SUITE 3509
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1004
Mailing Address - Country:US
Mailing Address - Phone:336-832-4380
Mailing Address - Fax:336-832-4382
Practice Address - Street 1:1200 N ELM ST
Practice Address - Street 2:SUITE 3509
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1004
Practice Address - Country:US
Practice Address - Phone:336-832-4380
Practice Address - Fax:336-832-4382
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-053702207R00000X
NC2010-01852207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine