Individual provider · NPI-1

Amjad Mahmoud Abualsuod, MD

Internal Medicine, Clinical Cardiac Electrophysiology · Peoria, IL

NPI number1427346444

StatusActive

Last updated in NPPESFeb 15, 2024

Details

NPI: 1427346444
Entity type: Individual (NPI-1)
Name: Amjad Mahmoud Abualsuod
Credential: MD
Sex: Male
Sole proprietor: No
Enumeration date: Jul 11, 2011
Certification date: Feb 15, 2024
Last updated: Feb 15, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207RC0001X	Internal Medicine, Clinical Cardiac Electrophysiology	036156509	IL	Yes
207RC0000X	Internal Medicine, Cardiovascular Disease	01082223A	IN
207RC0000X	Internal Medicine, Cardiovascular Disease	036156509	IL
207R00000X	Internal Medicine	036156509	IL

Practice location

5405 N Knoxville Ave
Peoria, IL 61614-5016

Phone 309-589-2050

Mailing address

5405 N Knoxville Ave
Peoria, IL 61614-5016

Phone 309-589-2050

Other practice locations

4301 W Markham St # 783
Little Rock, AR 72205-7101

Phone 501-686-8000 · Fax 501-526-6562

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