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General NPI Number Information
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NPI Number | 1326159310
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Entity Type | Organization
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Legal Business Name | THE CLINIC OF PEDIATRICS & GI MEDICINE, INC.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 102 MEDICAL CENTER DR
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City | PANAMA CITY
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State | FL
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Zip | 32405-4907
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Country | US
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Telephone | 850-913-1666
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Fax | 850-913-1549
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Provider Business Mailing Address
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Address Line | 102 MEDICAL CENTER DR
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City | PANAMA CITY
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State | FL
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Zip | 32405-4907
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Country | US
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Telephone | 850-913-1666
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Fax | 850-913-1549
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMMED M ZEINOMAR
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Credential | MD
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Telephone | 850-913-1666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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