Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 35065825 | OH |
NPI | 1003813262 |
---|---|
Provider Name | Abdul Halawa |
First Address | Twinsburg, OH 44087-3218 |
Second Address | Chardon, OH 44024-7025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G18738 | (02) | OH |