Mohannad Fadl Azzam, MD | |
2052 Blackridge Rd, Hoover, AL 35244-5243 | |
(205) 934-4794 | |
Not Available |
Full Name | Mohannad Fadl Azzam |
---|---|
Gender | Male |
Speciality | Physical Medicine & Rehabilitation |
Location | 2052 Blackridge Rd, Hoover, Alabama |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013141951 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | MD30737 (Alabama) | Secondary |
208100000X | Physical Medicine & Rehabilitation | 30737 (Alabama) | Primary |
Entity Name | Azzam Medical Services Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801203369 PECOS PAC ID: 0244459485 Enrollment ID: O20140919001445 |
Entity Name | Concentric Hospitalist Group Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740667138 PECOS PAC ID: 4082926449 Enrollment ID: O20150629001028 |
Entity Name | Oak Mountain Group Services, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366840761 PECOS PAC ID: 3678886256 Enrollment ID: O20150727000323 |
Entity Name | Diverse Medical Management, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1235548504 PECOS PAC ID: 5395965024 Enrollment ID: O20180215002874 |
Entity Name | Dermaccel Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1992582241 PECOS PAC ID: 7618323130 Enrollment ID: O20231019001715 |
Mailing Address | Practice Location Address |
---|---|
Mohannad Fadl Azzam, MD Po Box 361585, Hoover, AL 35236-1585 Ph: (205) 934-4794 | Mohannad Fadl Azzam, MD 2052 Blackridge Rd, Hoover, AL 35244-5243 Ph: (205) 934-4794 |
Jack David Denver, MD Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 1500 Southlake Park, Suite 150, Hoover, AL 35244 Phone: 205-874-9663 Fax: 205-874-9667 | |
Kerrie A Girouard, OT Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 4517 Southlake Pkwy, Hoover, AL 35244 Phone: 205-985-4111 Fax: 205-985-4326 | |
Connor Michael Brown, DPT Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 5266 Creekside Loop, Hoover, AL 35244 Phone: 205-937-7243 |