Healthcare Provider Details

I. General information

NPI: 1124540232
Provider Name (Legal Business Name): HAFEZ MOHAMMAD AMMAR ABDULLAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2017
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4460 RED BANK RD STE 200
CINCINNATI OH
45227-2173
US

IV. Provider business mailing address

4460 RED BANK RD STE 200
CINCINNATI OH
45227-2173
US

V. Phone/Fax

Practice location:
  • Phone: 513-321-4333
  • Fax: 513-533-6033
Mailing address:
  • Phone: 513-321-4333
  • Fax: 513-533-6033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35.156721
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35560
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number12066
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: