Provider Demographics
NPI:1285684092
Name:ABBAS, ABBAS EL SAYED (MD)
Entity Type:Individual
Prefix:
First Name:ABBAS
Middle Name:EL SAYED
Last Name:ABBAS
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:PO BOX 16149
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-0697
Mailing Address - Country:US
Mailing Address - Phone:401-453-9625
Mailing Address - Fax:401-435-7069
Practice Address - Street 1:2 DUDLEY ST STE 470
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3248
Practice Address - Country:US
Practice Address - Phone:401-553-8320
Practice Address - Fax:401-868-2322
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062770L208G00000X
RIMD17568208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1014753Medicaid
MS09680883Medicaid
OH2428886Medicaid
LA1014753Medicaid
LA4K7057061Medicare PIN
OHAB4121931Medicare PIN
H21213Medicare UPIN
MS09680883Medicaid