Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 57019 | TN |
N | 2086S0120X | Pediatric Surgery | 57621 | WI |
NPI | 1558619213 |
---|---|
Provider Name | Abdelhafeez H Abdelhafeez |
First Address | Memphis, TN 38105-3678 |
Second Address | Memphis, TN 38105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2012 |
Last Update Date | 08/08/2018 |