Healthcare Provider Details

I. General information

NPI: 1407088511
Provider Name (Legal Business Name): HAYTHAM HISHAM ALABBAS MD, MSC, FRCSC, FACS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2009
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PRINCE SAUD AL FAISAL, AR RAWDAH
JEDDAH MAKKAH
23433
SA

IV. Provider business mailing address

KING FAISAL SPECIALISTS HOSPITAL AND RESEARCH CENTER AR RADWAH DISTRIC
JEDDAH MAKKAH
23214
SA

V. Phone/Fax

Practice location:
  • Phone: 966-126-6777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number242001
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number129666
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: