Doctor Name: | ALFRED MUJEM |
NPI Number: | 1962762286 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 25000368211 |
Business Practice Address: | 3308 Chauncey Pl Apt 201 Mount Rainier, MD - 207121011 |
Business Phone Number: | 7085137708 |
Business Fax Number: | |
Mailing Address: | 3308 Chauncey Pl Apt 201, MOUNT RAINIER |
State: | MD |
Postal Code: | 207121011 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/21/2012 |
NPI Last Update Date: | 05/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 347C00000X |
License Number: | 25000368211 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Private Vehicle |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |