Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 82179 | SC |
NPI | 1104131143 |
---|---|
Provider Name | Anas Abdel Azim |
First Address | Cleveland, OH 44195-0001 |
Second Address | Greenwood, SC 29646-3808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2010 |
Last Update Date | 22/01/2020 |