Healthcare Provider Details

I. General information

NPI: 1508937491
Provider Name (Legal Business Name): MAHER A ABBAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 10/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE MAIL CODE JJN4
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

4425 CORONET DR
ENCINO CA
91316-4326
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-2200
  • Fax:
Mailing address:
  • Phone: 818-966-7947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberA54705
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: