Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | ME87903 | FL |
NPI | 1003924309 |
---|---|
Provider Name | Abdel F Eltomi |
First Address | Ponce Inlet, FL 32127-8050 |
Second Address | Augusta, ME 04333-0011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A24088 | (02) | FL |