Healthcare Provider Details

I. General information

NPI: 1588348155
Provider Name (Legal Business Name): ISLAM HAMZA MOHAMED ZAKI ABDELMOETI MBBCH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/14/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

BANK OF EGYPT TOWER, THE GREATEST SEA STREET APARTMENT 7, 8TH FLOOR
TALKHA DAKALHIYA
35681
EG

V. Phone/Fax

Practice location:
  • Phone: 202-259-0331
  • Fax: 202-476-3644
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMTL600101555
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: