Provider Demographics
NPI:1073969424
Name:AWWAB, HAJRA (MD)
Entity Type:Individual
Prefix:
First Name:HAJRA
Middle Name:
Last Name:AWWAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 EDDY STREET
Mailing Address - Street 2:RHODE ISLAND HOSPITAL-GRADUATE MEDICAL EDUCATION
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903
Mailing Address - Country:US
Mailing Address - Phone:401-444-8450
Mailing Address - Fax:401-444-5088
Practice Address - Street 1:593 EDDY STREET
Practice Address - Street 2:RHODE ISLAND HOSPITAL-GRADUATE MEDICAL EDUCATION
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903
Practice Address - Country:US
Practice Address - Phone:401-444-8450
Practice Address - Fax:401-444-5088
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP05612390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program