Healthcare Provider Details

I. General information

NPI: 1629424395
Provider Name (Legal Business Name): ASIL NAIM AL-ABED DAOUD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date: 01/03/2017
Reactivation Date: 11/14/2017

III. Provider practice location address

2825 E BARNETT RD
MEDFORD OR
97504-8332
US

IV. Provider business mailing address

2825 E BARNETT RD
MEDFORD OR
97504-8332
US

V. Phone/Fax

Practice location:
  • Phone: 541-789-4207
  • Fax:
Mailing address:
  • Phone: 541-789-4207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD213462
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: