Provider Demographics
NPI:1275305443
Name:MAOW, AMAL
Entity Type:Individual
Prefix:
First Name:AMAL
Middle Name:
Last Name:MAOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9307 TIBBLE CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-6673
Mailing Address - Country:US
Mailing Address - Phone:980-318-9352
Mailing Address - Fax:
Practice Address - Street 1:9307 TIBBLE CREEK WAY
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-6673
Practice Address - Country:US
Practice Address - Phone:980-318-9352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion