Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 25MA08715500 | NJ |
NPI | 1114034352 |
---|---|
Provider Name | Ahmed G. Mami |
First Address | Boston, MA 02241-6925 |
Second Address | Springfield, IL 62702-5310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 19/02/2020 |