Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | C10007711 | DE |
Y | 2084N0402X | Child Neurologist | C10007711 | DE |
NPI | 1154412443 |
---|---|
Provider Name | Dr. Omar Dabbagh |
First Address | Atlanta, GA 30384-0001 |
Second Address | Wilmington, DE 19803-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 07/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0077453 | (05) | NJ |
101468801 | (05) | PA |
4085400 | (05) | MD |
I40195 | (02) |