Healthcare Provider Details

I. General information

NPI: 1225199433
Provider Name (Legal Business Name): IRADJ AMIRLAK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EMIRATES INTERNATIONAL HOSPITAL AL KHABISI
AL AIN ABU DHABI
18088
AE

IV. Provider business mailing address

EMIRATES INTERNATIONAL HOSPITAL AL KHABISI
AL AIN ABU DHABI
18088
AE

V. Phone/Fax

Practice location:
  • Phone: 00971504414063
  • Fax: 97137636555
Mailing address:
  • Phone: 00971504414063
  • Fax: 97137636555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code281PC2000X
TaxonomyChildren's Chronic Disease Hospital
License Number82100
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: