Individual
AHMED MUTHANNA AL-TABAQCHALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 KINGSLEY AVE, ORANGE PARK, FL 32073-5148
(904) 639-8500
Mailing address
2220 E HAMMOND LAKE DR, BLOOMFIELD TWP, MI 48302
(212) 423-6271
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME169270
FL
Other
Enumeration date
06/02/2020
Last updated
08/16/2024
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