Doctor's Information

Your name

Professional Degree(s) e.g. MD, PhD

Academic Title e.g. Assistant Professor, Division Head

Patients you treat
AdultsPediatricsBoth

List areas of Medical Specialties

Your email (Please state if you do not want your e-mail published in your listing and IAES will only use it for private communication.)

Your Public e-mail e.g. office/clinic

Location/Country

Name of Hospital or Clinic

Street address

Address line 2

City

State/region

Postal Code

Telephone where patients and doctors can best reach you:

Telephone number for patient appointments:

Fax

Link to profile- mark N/A if not applicable

Website of hospital or clinic - mark N/A if not applicable

Link to published research - mark N/A if not applicable

Link to media interviews - mark N/A if not applicable

Social Media you would like to Include
FacebookTwitterLinkedinInstagramYouTubeOther

Please provide links in additional comments box

Additional Comments

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