Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME41430 | FL |
Y | 111NI0900X | Internist | ME41430 | FL |
N | 207RA0401X | Internist - Addiction Medicine | ME41430 | FL |
NPI | 1639172216 |
---|---|
Provider Name | Dr. Abib T Conteh |
First Address | Clearwater, FL 33757-8744 |
Second Address | Tampa, FL 33618-4404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2005 |
Last Update Date | 07/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
067577600 | (05) | FL |
D54055 | (02) | FL |