Provider Demographics
NPI:1033158076
Name:HESHAM ABDELKADER
Entity Type:Organization
Organization Name:HESHAM ABDELKADER
Other - Org Name:NONE
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICAL THERAPIST/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HESHAM
Authorized Official - Middle Name:HANFY
Authorized Official - Last Name:ABDELKADER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:810-503-0986
Mailing Address - Street 1:1248 N IRISH RD
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-2213
Mailing Address - Country:US
Mailing Address - Phone:810-503-0986
Mailing Address - Fax:810-503-0990
Practice Address - Street 1:1248 N IRISH RD
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-2213
Practice Address - Country:US
Practice Address - Phone:810-503-0986
Practice Address - Fax:810-503-0990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501006715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty