Individual
DR. RIZK M ABDEL MOUTAGALY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
715 GANDY ST, RUSSELLVILLE, AL 35653
(256) 332-1175
(256) 332-1171
Mailing address
PO BOX 580, RUSSELLVILLE, AL 35653
(256) 332-1175
(256) 332-1171
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22718
AL
208D00000X
General Practice Physician
22718
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000021621
—
AL
01
—
51021621
BLUE CROSS BLUE SHIELD
AL
Enumeration date
04/11/2006
Last updated
02/23/2010
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