Individual
IDRISS TOUIMI BENJELLOUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1929
(203) 852-2025
Mailing address
500 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1929
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101280489
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2021
Last updated
10/03/2024
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