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General NPI Number Information
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NPI Number | 1053355834
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Entity Type | Individual
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Provider Name | MONA S. ISMAIL M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 559 MUSKET BAY DR
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City | WILMINGTON
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State | NC
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Zip | 28412-5421
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Country | US
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Telephone | 917-455-8691
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Fax |
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Provider Business Mailing Address
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Address Line | 559 MUSKET BAY DR
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City | WILMINGTON
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State | NC
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Zip | 28412-5421
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Country | US
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Telephone | 347-690-0881
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2020-04074
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA07582300
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 25MA07582300
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 2020-04074
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License Number State | NC
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