Provider Demographics
NPI:1477529154
Name:KABIR, ABDUL (MD)
Entity Type:Individual
Prefix:
First Name:ABDUL
Middle Name:
Last Name:KABIR
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 2374
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161
Mailing Address - Country:US
Mailing Address - Phone:734-241-0366
Mailing Address - Fax:734-241-0680
Practice Address - Street 1:219 W FRONT ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161
Practice Address - Country:US
Practice Address - Phone:734-241-0366
Practice Address - Fax:734-241-0680
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301073277207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3509722Medicaid
G05574Medicare UPIN
MI3509722Medicaid