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General NPI Number Information
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NPI Number | 1548752793
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Entity Type | Individual
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Provider Name | ABRAHAM ABDULHAK MD
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Gender | Male
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Dates
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Enumeration Date | 06/04/2018
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 24924 MICHIGAN AVE
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City | DEARBORN
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State | MI
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Zip | 48124-1740
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Country | US
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Telephone | 313-631-3550
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Fax |
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Provider Business Mailing Address
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Address Line | 24924 MICHIGAN AVE
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City | DEARBORN
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State | MI
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Zip | 48124-1740
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Country | US
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Telephone | 313-663-0099
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 4301509082
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 4301509082
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License Number State | MI
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