Mt Internal Medicine Consulting LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MT INTERNAL MEDICINE CONSULTING LLC

Practice address

4465 Narrow Lane Rd
Montgomery, AL 36116-2953

Phone

(334) 284-7700

NPI assigned

Dec 19, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mina Ezzat Tawadrous, DONPI 1518450881

Title

Owner

Phone

(334) 277-8330

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mina Ezzat Tawadrous, DO

  • Internal Medicine Physician
  • Montgomery, AL
  • NPI 1518450881
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734566400000",
    "number": "1083422364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3644 LOCKWOOD LN",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361111548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 NARROW LANE RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162953",
            "telephone_number": "334-284-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT INTERNAL MEDICINE CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A",
        "authorized_official_last_name": "TAWADROUS",
        "authorized_official_first_name": "MINA",
        "authorized_official_middle_name": "EZZAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-277-8330",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mulberry Diagnostic Imaging
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• Internal Medicine Physician in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.