Provider Demographics
NPI:1083356703
Name:ABAS, ZEITHUN A (MS, RD, LD, CDCES)
Entity Type:Individual
Prefix:MRS
First Name:ZEITHUN
Middle Name:A
Last Name:ABAS
Suffix:
Gender:F
Credentials:MS, RD, LD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2271 HEMPSTEAD CT
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2329
Mailing Address - Country:US
Mailing Address - Phone:256-371-0549
Mailing Address - Fax:
Practice Address - Street 1:100 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3301
Practice Address - Country:US
Practice Address - Phone:678-312-4158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD004475133V00000X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered