Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 207R00000X | PA |
N | 111NI0900X | Internist | 207R00000X | PA |
Y | 2084N0400X | Neurologist | MD2014-0140 | NM |
NPI | 1003058157 |
---|---|
Provider Name | Dr. Kader Tawfiq Abdelerahman |
First Address | Albuquerque, NM 87102-2534 |
Second Address | Albuquerque, NM 87102-2534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2009 |
Last Update Date | 17/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00939854 | (05) | NM |