Healthcare Provider Details

I. General information

NPI: 1932957131
Provider Name (Legal Business Name): TARIK ABANOZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2024
Last Update Date: 03/29/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 SPRING HILL AVE STE 202
MOBILE AL
36604-1409
US

IV. Provider business mailing address

1720 SPRING HILL AVE STE 202
MOBILE AL
36604-1409
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-7554
  • Fax: 251-435-6629
Mailing address:
  • Phone: 251-435-7554
  • Fax: 251-435-6629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT231291
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: