Provider Demographics
NPI:1396367702
Name:ABUAITA, YARA T (DO)
Entity Type:Individual
Prefix:
First Name:YARA
Middle Name:T
Last Name:ABUAITA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 KING CHURCH AVE SW
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-5100
Mailing Address - Country:US
Mailing Address - Phone:330-877-0781
Mailing Address - Fax:
Practice Address - Street 1:432 KING CHURCH AVE SW
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-5100
Practice Address - Country:US
Practice Address - Phone:330-877-0781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-08
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151014611207Q00000X
OH34.016752207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine