Individual
MICHELLE IJAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 712-3329
Mailing address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 712-3329
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME154662
FL
208M00000X
Hospitalist Physician
ME154662
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/05/2018
Last updated
11/12/2024
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