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General NPI Number Information
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NPI Number | 1770921983
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Entity Type | Individual
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Provider Name | ABDL-RAWF AL-NOWAYLATI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2013
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 550 PEACHTREE ST NE FL MOT9
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City | ATLANTA
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State | GA
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Zip | 30308-2247
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Country | US
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Telephone | 404-686-4411
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 E. MEDICAL CENTER DR. 2130 TAUBMAN CENTER, SPC 5340
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City | ANN ARBOR
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State | MI
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Zip | 48109
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Country | US
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Telephone | 734-232-4598
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 4301504883
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 92452
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License Number State | GA
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