Healthcare Provider Details
I. General information
NPI: 1538620877
Provider Name (Legal Business Name): AHMED MOHAMED KAMAL HALIMA M.B.B.CH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/28/2019
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 N ACADEMY AVE
DANVILLE PA
17822-9800
US
IV. Provider business mailing address
455 MAIN ST APT 6Q
NEW YORK NY
10044-0196
US
V. Phone/Fax
- Phone: 570-271-6144
- Fax:
- Phone: 646-770-6877
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | MD484788 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: