Provider Demographics
NPI:1093912362
Name:ABU HAZEEM, ANAS ABDEL HALEEM (MD)
Entity Type:Individual
Prefix:DR
First Name:ANAS
Middle Name:ABDEL HALEEM
Last Name:ABU HAZEEM
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 1:13001 E 17TH PL
Mailing Address - Street 2:UNIVERSITY OF COLORADO SCHOOL OF MEDICINE GME
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2570
Mailing Address - Country:US
Mailing Address - Phone:720-777-2940
Mailing Address - Fax:720-777-7290
Practice Address - Street 1:13001 E. 17TH PLACE
Practice Address - Street 2:UNIVERSITY OF COLORADO SCHOOL OF MEDICINE GME
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2581
Practice Address - Country:US
Practice Address - Phone:720-777-2940
Practice Address - Fax:720-777-7290
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL.0004562390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program