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General NPI Number Information
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NPI Number | 1902203201
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Entity Type | Organization
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Legal Business Name | A&B INTERNAL MEDICINE LLC
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Dates
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Enumeration Date | 12/02/2014
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Last Update Date | 12/02/2014
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Provider Practice Location Address
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Address Line | 1150 W 24TH ST STE E
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City | YUMA
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State | AZ
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Zip | 85364-8368
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Country | US
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Telephone | 928-783-3445
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Fax | 520-378-0123
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Provider Business Mailing Address
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Address Line | 1150 W 24TH ST STE E
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City | YUMA
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State | AZ
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Zip | 85364-8368
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Country | US
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Telephone | 928-783-3445
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Fax | 520-378-0123
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Authorized Official
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Title or Position | OWNER
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Name | MR. SAMIR T MOUSTAFA
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Credential |
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Telephone | 928-246-0261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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