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General NPI Number Information
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NPI Number | 1053351494
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Entity Type | Individual
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Provider Name | MONA ABDELGALIL IMAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 210 N 7TH ST STE 101
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City | MARIETTA
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State | OH
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Zip | 45750-2244
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Country | US
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Telephone | 740-373-0669
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Fax | 740-568-5228
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Provider Business Mailing Address
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Address Line | PO BOX 449
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City | MARIETTA
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State | OH
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Zip | 45750-0449
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 35073285
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License Number State | OH
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