NPIMap

Organization Active NPI

Azzam Adhal, M.D.

  • Internal Medicine Physician
  • Panama City, FL
National Provider Identifier
1518360288
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME39621 Issued in FL
Legal business name
AZZAM ADHAL, M.D.
Practice address
2195 Jenks Ave Ste B
Panama City, FL 32405-4683
Phone
(850) 784-6696
Fax
(850) 785-2100
NPI assigned
Oct 8, 2014
Last updated
Nov 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Authorized official

Name
Azzam Adhal, MDNPI 1295714129
Title
Owner
Phone
(850) 784-6696

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME39621 FL Primary

Addresses

Primary practice location

2195 Jenks Ave Ste B
Panama City, FL 32405-4683

Mailing address

PO Box 15909
Panama City, FL 32406-5909
Phone (850) 784-6696

Other identifiers 1

IdentifierTypeStateIssuer
1295714129OtherFLINDIVIDUAL NPI

National Provider Directory

National Provider Directory

Locations

2195 Jenks Ave
Ste B
Panama City, FL 32405
Phone (850) 774-8484

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1518360288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15909",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324065909",
            "telephone_number": "850-784-6696",
            "fax_number": "850-785-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 JENKS AVE STE B",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054683",
            "telephone_number": "850-784-6696",
            "fax_number": "850-785-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZZAM ADHAL, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-08",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "ADHAL",
        "authorized_official_first_name": "AZZAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-784-6696",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME39621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1295714129",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.