Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 27654 | AL |
NPI | 1043269061 |
---|---|
Provider Name | Dr. Mamoun I Najjar |
First Address | Decatur, AL 35602-1684 |
Second Address | Decatur, AL 35601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 18/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051559657 | (05) | AL |
51048267 | BCBS (01) | AL |
I11623 | (02) |