Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 35078530 | OH |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 35078530 | OH |
NPI | 1063409324 |
---|---|
Provider Name | Dr. Abdul Azim Mustapha |
First Address | Toledo, OH 43614-2426 |
Second Address | Toledo, OH 43614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2005 |
Last Update Date | 06/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2210584 | (05) | OH |
H28250 | (02) |