Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 01085402A | IN |
N | 207RG0100X | Gastroenterologist | ME149761 | FL |
NPI | 1023436037 |
---|---|
Provider Name | Ali Mohammed Syed |
First Address | Bangor, ME 04401-6616 |
Second Address | Bangor, ME 04401-6616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2014 |
Last Update Date | 18/10/2021 |