Provider Demographics
NPI:1366854044
Name:AZZOUQAH, OLA MUSTAFA ABDEL GHANI (MD)
Entity type:Individual
Prefix:MS
First Name:OLA
Middle Name:MUSTAFA ABDEL GHANI
Last Name:AZZOUQAH
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1 UNIVERSITY OF NEW MEXICO
Mailing Address - Street 2:MSC 10 5550
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-6331
Mailing Address - Fax:505-272-0475
Practice Address - Street 1:1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:MSC 10 5550
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-6331
Practice Address - Fax:505-272-0475
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2023-07-24
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Provider Licenses
StateLicense IDTaxonomies
NMRS2014-0351390200000X
390200000X
NMMD2018-0838207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program