Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MD16555 | RI |
Y | 111NI0900X | Internist | MD16555 | RI |
NPI | 1003369042 |
---|---|
Provider Name | Mahmoud Mowafy |
First Address | Pawtucket, RI 02860-4474 |
Second Address | Pawtucket, RI 02860-4474 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2016 |
Last Update Date | 20/03/2019 |