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General NPI Number Information
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NPI Number | 1720963069
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Entity Type | Individual
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Provider Name | MUNJED AL MUDERIS MB CHB FRACS FAORTHA
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Gender | Male
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 901 45TH STREET, KIMMEL BUILDING
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City | WEST PALM BEACH
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State | FL
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Zip | 33407
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Country | US
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Telephone | 561-844-5255
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 20802
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City | BELFAST
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State | ME
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Zip | 04915-4105
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Country | US
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Telephone | 888-402-7256
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Fax | 888-902-1099
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME175968
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License Number State | FL
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