Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | H0090695 | MD |
NPI | 1093249088 |
---|---|
Provider Name | Dr. Suzanne Aly Abdelazim |
First Address | Fulton, MD 20759-2694 |
Second Address | Fulton, MD 20759-2565 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2017 |
Last Update Date | 23/08/2021 |