Wisam Al-Mutawalli, MD

NPI #1164005526 in Camillus, New York

Provider Information

NPI Number: 1164005526
Entity Type: Individual
Name: Wisam Al-Mutawalli, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: MD
Enumeration Date: May 4, 2021
Last Updated: Oct 23, 2024

Practice Location

Address: 208 TOWNSHIP BLVD
Address 2: STE 100
City: Camillus
State: New York
ZIP Code: 13031
Phone: (315) 551-6000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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