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NPI Code Detail

MEDICARE: MINA EZZAT TAWADROUS DO

MEDICARE: MINA EZZAT TAWADROUS DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianDO2151AL

General Provider Information

NPI Number : 1518450881
Entity Type Code : Individual
Provider Name (Legal Business Name) : MINA EZZAT TAWADROUS DO
Provider Business Mailing Address
First Line : 400 TAYLOR RD
Second Line :
City : MONTGOMERY
State : AL
Zip : 36117-3511
Country : US
Telephone Number : 334-277-8330
Fax Number :
Provider Business Practice Location Address
First Line : 400 TAYLOR RD
Second Line :
City : MONTGOMERY
State : AL
Zip : 36117-3511
Country : US
Telephone Number : 334-277-8330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2018
Last Update Date : 10/12/2021

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Directions to “ MINA EZZAT TAWADROUS DO” Practice Location

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