Provider Demographics
NPI:1861541336
Name:ELRAFEI, MOHAMED S (DDS)
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:S
Last Name:ELRAFEI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7308 TRAPPE ST
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2613
Mailing Address - Country:US
Mailing Address - Phone:410-428-6172
Mailing Address - Fax:
Practice Address - Street 1:7308 TRAPPE ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2613
Practice Address - Country:US
Practice Address - Phone:410-428-6172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12570122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist