Individual
DR. MAMDOUH N MIJALLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 N 8TH AVE, SUITE 2B, DILLON, SC 29536-2549
(843) 841-3846
(843) 841-3848
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 841-3846
(843) 841-3848
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
29714
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
297146
—
SC
Enumeration date
11/23/2006
Last updated
02/22/2021
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