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General NPI Number Information
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NPI Number | 1760753636
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Entity Type | Individual
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Provider Name | MAGED MOKHTAR BAKR M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 08/09/2017
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Provider Practice Location Address
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Address Line | 311 9TH ST N STE 304
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City | NAPLES
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State | FL
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Zip | 34102-5885
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Country | US
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Telephone | 239-624-2730
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Fax | 239-624-2731
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Provider Business Mailing Address
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Address Line | 311 9TH ST N STE 304
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City | NAPLES
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State | FL
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Zip | 34102-5885
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Country | US
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Telephone | 239-624-2730
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Fax | 239-624-2731
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME 122337
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License Number State | FL
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