Transcription of PRACTICE NUMBER APPLICATION - NAMAF
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Example: bachelor of science
PRACTICE NUMBER APPLICATION - NAMAF
Conditions: Submission of APPLICATION form does not provide automatic access to a PRACTICE NUMBER . The process of granting a healthcare provider with a PRACTICE NUMBER is subject to the completeness of this document. No 8. Newton Street Failure to complete the form in full and submit all supporting Windhoek, Namibia documentation may result the processing of your APPLICATION P. O. Box 11974. being delayed. NAMAF will not accept any responsibility for Klein Windhoek incomplete submissions. Tel: 264 61 257211/2. Should a PRACTICE NUMBER be granted / renewed it will be done Fax: 264 61 257213. on the assumption that all information contained herein is of a Mail: truthful nature and therefore correct. Website: Date of APPLICATION : . Name in which PRACTICE NUMBER will be allocated (Prof., Dr., Sr., Mr., Mrs., Ms., Name of Facility, etc.): .. PRACTICE NUMBER APPLICATION .. Trading Name: .. Scope of PRACTICE .
6 k. if joining an existing group or multi-disciplinary practice, provide practice number of such group or multi-disciplinary practice:
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