Healthcare Provider Details

I. General information

NPI: 1386087443
Provider Name (Legal Business Name): ABDUALRAHMAN HAMAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6777 W MAPLE RD
WEST BLOOMFIELD MI
48322-3013
US

IV. Provider business mailing address

2727 GRAMERCY ST STE 200
HOUSTON TX
77025-1716
US

V. Phone/Fax

Practice location:
  • Phone: 248-661-5100
  • Fax:
Mailing address:
  • Phone: 713-799-9975
  • Fax: 713-799-1095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberR2354
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number4301116922
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: