Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
WISAM AL-MUTAWALLI, MD
ActiveWISAM AL-MUTAWALLI, MD is a Family Medicine healthcare provider located in CAMILLUS, New York. NPI 1164005526 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · CAMILLUS, NY
Registration Details
- NPI Number
- 1164005526
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 4, 2021 (5.0981364342429 yrs)
- Last Updated
- Oct 23, 2024
- License
-
332191 (NY)
Practice Information
- Address
-
208 TOWNSHIP BLVDSTE 100CAMILLUS, NY, 13031Browse NY providers · Browse ZIP 13031
- Phone
- 3155516000
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in CAMILLUS, NY
| Name | Credential | NPI |
|---|---|---|
| THOMAS J LACLAIR | MD | 1003819053 |
| DAVID THURBER PAGE | MD | 1114920287 |
| STEVEN M CONNOLLY | MD | 1639172414 |
| JAMES FRANCIS LAWLESS | MD | 1114910874 |
| JOHN NIKOLA TALEV | MD | 1841275435 |
| DENNIS DAVID DALY | MD | 1073598660 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.