Provider Demographics
NPI:1861761538
Name:HAFEZ, MHD NAZEM (MD)
Entity type:Individual
Prefix:
First Name:MHD NAZEM
Middle Name:
Last Name:HAFEZ
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 1:9500 EUCLID AVE
Mailing Address - Street 2:HOSPITALIST MEDICINE - M2-ANNEX
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-445-0346
Mailing Address - Fax:216-444-8530
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:HOSPITALIST MEDICINE - M2-ANNEX
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-0346
Practice Address - Fax:216-444-8530
Is Sole Proprietor?:No
Enumeration Date:2011-12-23
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.128128174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program