Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | 35404 | AL |
NPI | 1205383023 |
---|---|
Provider Name | Ismail Sidky Mohamed |
First Address | Birmingham, AL 35249-6539 |
Second Address | Birmingham, AL 35249-6539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2016 |
Last Update Date | 13/02/2017 |