Individual
AMUTALLAH ABDUSSALAAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
3640 HIGH ST STE 1E, PORTSMOUTH, VA 23707-3213
(757) 399-2639
Mailing address
3640 HIGH ST STE 1E, PORTSMOUTH, VA 23707-3213
(757) 399-2639
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024192072
VA
Other
Enumeration date
12/18/2024
Last updated
12/18/2024
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