Provider Demographics
NPI:1073779492
Name:JAMA, ABAS M (MD)
Entity Type:Individual
Prefix:MR
First Name:ABAS
Middle Name:M
Last Name:JAMA
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 1:1031 PIERCE ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-4669
Mailing Address - Country:US
Mailing Address - Phone:419-557-5541
Mailing Address - Fax:419-557-5542
Practice Address - Street 1:1221 HAYES AVE
Practice Address - Street 2:SUITE J
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-3345
Practice Address - Country:US
Practice Address - Phone:419-557-6787
Practice Address - Fax:419-621-0127
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350951672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3050479Medicaid