Individual provider · NPI-1

Dr. Mohammed Shoaib Jameel Kidwai, MD

Internal Medicine · Bala Cynwyd, PA

NPI number1790969319
StatusActive
Last updated in NPPESOct 9, 2018

Details

NPI
1790969319
Entity type
Individual (NPI-1)
Name
Dr. Mohammed Shoaib Jameel Kidwai
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Dec 18, 2007
Last updated
Oct 9, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineMD433668PAYes
207R00000X Internal Medicine35.134997OH
207R00000X Internal MedicineTP985KY
208M00000X Hospitalist35.134997OH
208M00000X HospitalistTP985KY

Practice location

333 E City Ave Ste Pl50
Bala Cynwyd, PA 19004-1505

Phone 610-667-1115

Mailing address

4233 Remo Crescent Rd
Bensalem, PA 19020-2976

Phone 215-639-1492

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