Healthcare Provider Details

I. General information

NPI: 1043298151
Provider Name (Legal Business Name): HIND OBID M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 07/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 W 23RD ST
PANAMA CITY FL
32405-3928
US

IV. Provider business mailing address

951 W 23RD ST
PANAMA CITY FL
32405-3928
US

V. Phone/Fax

Practice location:
  • Phone: 850-785-0699
  • Fax: 850-872-9899
Mailing address:
  • Phone: 850-785-0699
  • Fax: 850-872-9899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number48601
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: