Individual
MR. MEDHAT ALLAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
365 COUNTY ROAD 39A, SUITE 11, SOUTHAMPTON, NY 11968-5284
(631) 287-6202
Mailing address
365 COUNTY ROAD 39A, SUITE 11, SOUTHAMPTON, NY 11968-5284
(631) 287-6202
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
193888
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01649430
—
NY
01
—
193888
LICENSE #
NY
Enumeration date
07/18/2005
Last updated
07/08/2007
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