Basic Information
| Provider Information | |||||||||
| NPI: | 1164155818 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABDELFATTAH | ||||||||
| FirstName: | MOHAMED | ||||||||
| MiddleName: | MAHER FATHY MOSTAFA | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8964 15TH AVENUE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187516008 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2041 GEORGIA AVENUE, NW, HOWARD UNIVERSITY HOSPITAL | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 20060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028656100 | ||||||||
| FaxNumber: | 2027453731 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2022 | ||||||||
| LastUpdateDate: | 07/08/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.