Individual
MUTAZ M LABIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 BREWSTER STREET, MEMORIAL HOSPITAL OF RHODE ISLAND, PAWTUCKET, RI 02860
(401) 729-3481
Mailing address
395 BROWN ST, UNIT # 16, ATTLEBORO, MA 02703-7475
(281) 704-6284
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
230630
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MD13433
RI
207RP1001X
Pulmonary Disease Physician
MD13433
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000361606
MEDICARE PTAN
RI
05
—
ML82503
—
RI
Enumeration date
01/11/2007
Last updated
08/15/2011
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