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Individual

NASSER PILOTIN SAMUY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
105 E WATTS ST, ENTERPRISE, AL 36330-2511
(334) 393-5437
(334) 489-4438
Mailing address
1414 ELBA HWY, TROY, AL 36079-6020
(334) 670-6726
(334) 670-6731

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO.1093
AL
207Q00000X
Family Medicine Physician
OT011895
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
142098
AL
Enumeration date
08/06/2009
Last updated
06/14/2022
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