Provider Demographics
NPI:1174253611
Name:AMOR, MAAMOON MOATASIM (MD)
Entity Type:Individual
Prefix:DR
First Name:MAAMOON
Middle Name:MOATASIM
Last Name:AMOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 HOSPITAL DRIVE MA423
Mailing Address - Street 2:DC 043.00
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65212
Mailing Address - Country:US
Mailing Address - Phone:573-882-7901
Mailing Address - Fax:
Practice Address - Street 1:1 HOSPITAL DRIVE MA423
Practice Address - Street 2:DC 043.00
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212
Practice Address - Country:US
Practice Address - Phone:573-882-7901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20230167162085R0202X
MO2022021346207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine