Organization
COMMONS DRIVE FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMAD S KALOU MD (OWNER)
(304) 552-7412
Entity
Organization
Contact information
Practice address
4012 COMMONS DR W STE 112, DESTIN, FL 32541-8424
(304) 552-7412
Mailing address
4012 COMMONS DR W STE 112, DESTIN, FL 32541-8424
(304) 552-7412
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME119611
FL
Other
Enumeration date
08/06/2015
Last updated
08/06/2015
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