Basic Information
| Provider Information | |||||||||
| NPI: | 1306264312 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAMAL | ||||||||
| FirstName: | FAISAL | ||||||||
| MiddleName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 132 SOUTH 10TH STREET | ||||||||
| Address2: | 480 MAIN BUILDING | ||||||||
| City: | PHILA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191075245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159558900 | ||||||||
| FaxNumber: | 2159555245 | ||||||||
| Practice Location | |||||||||
| Address1: | 132 SOUTH 10TH STREET | ||||||||
| Address2: | 480 MAIN BUILDING | ||||||||
| City: | PHILA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191075245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159558900 | ||||||||
| FaxNumber: | 2159555245 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2014 | ||||||||
| LastUpdateDate: | 06/16/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | MD477778 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | MD477778 | 01 | PA | PA LICENSE NUMBER | OTHER |