Mohannad Gamal Ahmed Abdeltawwab, MBBCH
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Cincinnati, OH
NPI 1104715986 · NPPES record last updated Jun 28, 2025
Key facts
- NPI
- 1104715986
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- 57257957 (OH)
- Practice address
- 375 Dixmyth Ave
Cincinnati, OH 45220-2475 - Phone
- (513) 862-1800
- Fax
- (513) 751-8638
- NPI assigned
- Jun 28, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250717000250 | OH | Order and Referring Only - Internal Medicine |
0143735159 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 57257957 | OH | Yes |
Addresses
Primary practice location
375 Dixmyth Ave
Cincinnati, OH 45220-2475
Mailing address
249 Senator PL Apt 10
Cincinnati, OH 45220-1768
Phone (513) 203-9213
Other providers in Cincinnati, OH
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- Mohamed Abdelaziz Elsayed El Abdelaziz
- Ahmed Abdelhaleem
- Donna Abdelnour
- Lamiaa Mohamed Ibrahim Abdelrehim
- Angela Gwen Abdon
- Alrawy Ali Mohammad Abdou
- Hana Shakir Abdul-Majid
- Eman M Abdulfatah
- Hafez Mohammad Ammar Abdullah
All providers in Cincinnati, OH · Student in an Organized Health Care Education/Training Program in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.