Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 2002023331 | MO |
NPI | 1023025707 |
---|---|
Provider Name | Abdul Mateen Nagaria |
First Address | Joplin, MO 64803-3810 |
Second Address | Joplin, MO 64804-3932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 02/06/2021 |