Healthcare Provider Details

I. General information

NPI: 1639598444
Provider Name (Legal Business Name): AMEER ABUTALEB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 07/18/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST ROOM N3E09
BALTIMORE MD
21201-1544
US

IV. Provider business mailing address

22 S GREENE ST ROOM N3E09
BALTIMORE MD
21201-1544
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-6110
  • Fax:
Mailing address:
  • Phone: 410-328-6110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberMD044618
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: