Provider Demographics
NPI:1053676049
Name:ALARHAYEM, ABDUL QADER SUFYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDUL QADER
Middle Name:SUFYAN
Last Name:ALARHAYEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-2827
Mailing Address - Country:US
Mailing Address - Phone:210-784-7281
Mailing Address - Fax:
Practice Address - Street 1:419 S WASHINGTON ST STE 101
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2951
Practice Address - Country:US
Practice Address - Phone:307-577-1003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2024-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT41042086S0129X
AZ598002086S0129X
MO20220110412086S0129X
WY16292A2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1053676049Medicaid