Healthcare Provider Details

I. General information

NPI: 1093198632
Provider Name (Legal Business Name): HAMDY MOHAMED ABDELAZIZ AHMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 STANTON RD
MOBILE AL
36617-2344
US

IV. Provider business mailing address

PO BOX 746450
ATLANTA GA
30374-6450
US

V. Phone/Fax

Practice location:
  • Phone: 251-471-7207
  • Fax: 251-471-7468
Mailing address:
  • Phone: 251-434-3626
  • Fax: 251-445-2464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD.37218
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: