NPI 1013390434 · live from the CMS NPI Registry
Mohamed Moneeb Abdellatif Azab, M.D
Internal Medicine, Gastroenterology in Green Bay, WI. National Provider Identifier 1013390434, active.
NPI record
| NPI | 1013390434 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine, Gastroenterology 207RG0100X |
| Practice location | 1726 Shawano Ave, Green Bay, WI 54303 |
| Practice phone | 920-496-4700 |
| Enumerated | July 2, 2015 |
| Last updated | May 11, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Internal Medicine, Gastroenterology primary | 207RG0100X | 75068-20 (WI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.