Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 4301075273 | MI |
NPI | 1013904093 |
---|---|
Provider Name | Abdul Kadar Alawwa |
First Address | Lapeer, MI 48446-1136 |
Second Address | Lapeer, MI 48446-1136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2005 |
Last Update Date | 10/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4906164 | (05) | MI |
4909961 | (05) | MI |
F03292 | (02) |