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General NPI Number Information
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NPI Number | 1003813262
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Entity Type | Individual
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Provider Name | ABDUL HALAWA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 13170 RAVENNA RD SUITE 206
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City | CHARDON
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State | OH
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Zip | 44024-7025
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Country | US
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Telephone | 440-739-0420
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Fax |
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Provider Business Mailing Address
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Address Line | 2653 BRONSONS WAY
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City | TWINSBURG
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State | OH
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Zip | 44087-3218
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Country | US
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Telephone | 330-963-5966
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 35065825
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License Number State | OH
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