Provider Demographics
NPI:1528819141
Name:AL-ASSIL, TALAL
Entity type:Individual
Prefix:
First Name:TALAL
Middle Name:
Last Name:AL-ASSIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 OSBORNE ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-5602
Mailing Address - Country:US
Mailing Address - Phone:619-701-2374
Mailing Address - Fax:
Practice Address - Street 1:927 OSBORNE ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-5602
Practice Address - Country:US
Practice Address - Phone:619-701-2374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program