Provider Demographics
NPI:1679661102
Name:TAGELDIN, MAGDI (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGDI
Middle Name:
Last Name:TAGELDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7626 SPANISH FORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORT
Mailing Address - State:AL
Mailing Address - Zip Code:36527-5376
Mailing Address - Country:US
Mailing Address - Phone:251-288-2750
Mailing Address - Fax:251-586-8599
Practice Address - Street 1:7626 SPANISH FORT BLVD
Practice Address - Street 2:
Practice Address - City:SPANISH FORT
Practice Address - State:AL
Practice Address - Zip Code:36527-5376
Practice Address - Country:US
Practice Address - Phone:251-288-2750
Practice Address - Fax:251-586-8599
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29986174400000X, 2084P0802X
FLME1153082084P0800X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No174400000XOther Service ProvidersSpecialist
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL29986OtherAL STATE LICENSE
FLME115308OtherFLORIDA STATE LICENSE