Provider Demographics
NPI:1164165924
Name:ABOBAKER, ANIS M ALKATEB (MD)
Entity Type:Individual
Prefix:MR
First Name:ANIS
Middle Name:M ALKATEB
Last Name:ABOBAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1270 PRINCE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606
Mailing Address - Country:US
Mailing Address - Phone:706-475-7055
Mailing Address - Fax:706-475-6820
Practice Address - Street 1:1270 PRINCE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606
Practice Address - Country:US
Practice Address - Phone:706-475-7055
Practice Address - Fax:706-475-6820
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program