Individual
EMAN MAZLOUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 RAWLINS DR, SEAFORD, DE 19973-5881
(302) 990-3300
Mailing address
1836 SOUTH MACARTHUR BOULEVARD, SPRINGFIELD, IL 62704
(217) 789-1403
(217) 789-1825
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036143373
IL
207Q00000X
Family Medicine Physician
Primary
C1-0012625
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207Q00000X
—
DE
Enumeration date
07/02/2014
Last updated
11/27/2018
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