Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 00309 | NC |
NPI | 1013964873 |
---|---|
Provider Name | Manal F Abdelmalek |
First Address | Durham, NC 27704-2121 |
Second Address | Durham, NC 27704-2121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 04/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
14198 | BCBS (01) | NC |
F59683 | (02) |