Healthcare Provider Details

I. General information

NPI: 1598290082
Provider Name (Legal Business Name): SAMIH J. NASSIF ABUDINEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2017
Last Update Date: 08/24/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1963 MEMORIAL PARKWAY SW SUITE 5
HUNTSVILLE AL
35801-5035
US

IV. Provider business mailing address

1963 MEMORIAL PARKWAY SW SUITE 5
HUNTSVILLE AL
35801-5035
US

V. Phone/Fax

Practice location:
  • Phone: 256-536-9300
  • Fax: 256-535-9032
Mailing address:
  • Phone: 256-536-9300
  • Fax: 256-535-9032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number271532
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: