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Individual

MOHANNAD FADL AZZAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2052 BLACKRIDGE RD, HOOVER, AL 35244-5243
(205) 934-4794
Mailing address
PO BOX 361585, HOOVER, AL 35236-1585
(205) 934-4794

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD30737
AL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
30737
AL

Other

Enumeration date
05/06/2009
Last updated
06/28/2024
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