MEDICARE: MR. ABDELLAH CHOUKHMANE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1629844311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ABDELLAH CHOUKHMANE

Provider Business Mailing Address
First Line	:	6217 BLYNN DR APT 4
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572-3247
Country	:	US
Telephone Number	:	843-602-0341
Fax Number	:

Provider Business Practice Location Address
First Line	:	6217 BLYNN DR APT 4
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572-3247
Country	:	US
Telephone Number	:	843-602-0341
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2023
Last Update Date	:	12/04/2023

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Directions to “ MR. ABDELLAH CHOUKHMANE ” Practice Location

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