Individual
MR. MOHAMMAD FATEH ISMAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
STAFF OF LIFE MEDICAL CORP PC, 1011 LEIGHTON AVE, ANNISTON, AL 36207-5701
(256) 770-7197
(256) 405-4439
Mailing address
1011 LEIGHTON AVE, ANNISTON, AL 36207-5701
(256) 770-7197
(256) 405-4439
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19946
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139280
—
AL
05
—
141757
—
AL
05
—
158627
—
AL
01
—
51518333
BLUE CROSS
AL
Enumeration date
07/12/2006
Last updated
09/29/2022
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