Healthcare Provider Details

I. General information

NPI: 1497105373
Provider Name (Legal Business Name): SAMUEL H ABBAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2016
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 CORPORATE DR STE 200
BIRMINGHAM AL
35242-2733
US

IV. Provider business mailing address

5410 MARYLAND WAY STE 400
BRENTWOOD TN
37027-8087
US

V. Phone/Fax

Practice location:
  • Phone: 855-212-2273
  • Fax:
Mailing address:
  • Phone: 855-212-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLL39872
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number59435
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number49504
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: