Provider Demographics
NPI:1942402243
Name:BAYOUMY, ABDEL-AZIM (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDEL-AZIM
Middle Name:
Last Name:BAYOUMY
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:PO BOX 2098
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-0050
Mailing Address - Country:US
Mailing Address - Phone:850-215-3001
Mailing Address - Fax:850-215-3668
Practice Address - Street 1:509 E 23RD ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-5307
Practice Address - Country:US
Practice Address - Phone:850-215-3001
Practice Address - Fax:850-215-3668
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 99491207R00000X
CT044718207R00000X
NY313104208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL279435700Medicaid
FL03055OtherBLUE CROSS
FLAH361ZMedicare PIN