Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | DN18413 | FL |
Y | 1223G0001X | General Practice | 08391 | IA |
Y | 213EG0000X | General Practice | 08391 | IA |
N | 1223G0001X | General Practice | 6513 | NE |
N | 213EG0000X | General Practice | 6513 | NE |
NPI | 1730244948 |
---|---|
Provider Name | Aly Hany Morshed |
First Address | Panama City, FL 32404-5831 |
Second Address | Panama City, FL 32404-5831 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 18/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001389900 | (05) | FL |
01454 | BLUE CROSS BLUE SHIELD (01) | IA |
05082 | BLUE CROSSBLUE SHIELD (01) | NE |
08391 | DELTA DENTAL (01) | IA |
10024989800 | (05) | NE |
1583088 | (05) | IA |
DN18413 | FLORIDA LICENSE (01) | FL |