Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 258806 | MA |
Y | 2080P0214X | Pediatric Pulmonologist | 225653 | NC |
N | 2080P0214X | Pediatric Pulmonologist | 258806 | MA |
N | 2080P0214X | Pediatric Pulmonologist | ME114366 | FL |
NPI | 1265548499 |
---|---|
Provider Name | Dr. Mai Kamal El Mallah |
First Address | Durham, NC 27710-0001 |
Second Address | Durham, NC 27710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 26/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007206400 | (05) | FL |
110100625A | (05) | MA |
177152901 | (05) | TX |
I47500 | (02) | TX |
S400170191 | MEDICARE (01) | MA |