Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DRPM2167 | FL |
NPI | 1487271888 |
---|---|
Provider Name | Shawki Abed |
First Address | Gainesville, FL 32606-5192 |
Second Address | Gainesville, FL 32611-2025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2020 |
Last Update Date | 01/07/2020 |