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General NPI Number Information
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NPI Number | 1477131134
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Entity Type | Individual
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Provider Name | FAWAZ KATMEH MD
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Gender | Male
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Dates
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Enumeration Date | 04/01/2021
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 100 WHETSTONE PL STE 105
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-5775
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Country | US
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Telephone | 904-824-3777
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Fax | 904-824-6050
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Provider Business Mailing Address
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Address Line | PO BOX 740861
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City | ATLANTA
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State | GA
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Zip | 30374-0861
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Country | US
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Telephone |
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Fax | 904-819-4906
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME167408
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License Number State | FL
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