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Individual

MOUSTAFA M. AOUTHMANY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636
(559) 353-3000
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
01074192A
IN
2080N0001X
Neonatal-Perinatal Medicine Physician
35065614
OH
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
C145911
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000965541
BCBS NICU
01
000000965558
BCBS MFM
IN
05
0225778
OH
05
201258820
IN
Enumeration date
09/29/2005
Last updated
03/01/2022
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