Healthcare Provider Details

I. General information

NPI: 1114768686
Provider Name (Legal Business Name): TAHER MAJID MANDO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2024
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 UNIVERSITY HOSPITAL DR # 316
MOBILE AL
36617-2300
US

IV. Provider business mailing address

2451 UNIVERSITY HOSPITAL DR # 316
MOBILE AL
36617-2300
US

V. Phone/Fax

Practice location:
  • Phone: 251-471-7000
  • Fax: 251-471-7096
Mailing address:
  • Phone: 251-471-7000
  • Fax: 251-471-7096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number207P00000X
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: