Provider Demographics
NPI:1700852043
Name:LOTFY, NERMEIN MOHAMED (MD)
Entity Type:Individual
Prefix:
First Name:NERMEIN
Middle Name:MOHAMED
Last Name:LOTFY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 WILL HALSEY WAY STE A
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2566
Mailing Address - Country:US
Mailing Address - Phone:256-325-2763
Mailing Address - Fax:
Practice Address - Street 1:708 WILL HALSEY WAY STE A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2566
Practice Address - Country:US
Practice Address - Phone:256-325-2763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL026324208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL175786Medicaid
G79149Medicare UPIN
G79149Medicare UPIN