Provider Demographics
NPI:1477542934
Name:SAIZ, ABEDON ABE (MD)
Entity Type:Individual
Prefix:
First Name:ABEDON
Middle Name:ABE
Last Name:SAIZ
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 1:90 RIVIERA DR
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-5716
Mailing Address - Country:US
Mailing Address - Phone:928-453-2900
Mailing Address - Fax:877-864-6566
Practice Address - Street 1:90 RIVIERA DR
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5716
Practice Address - Country:US
Practice Address - Phone:928-453-2900
Practice Address - Fax:877-864-6566
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24387208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ368557Medicaid
AZ368557Medicaid
AZZ66785Medicare PIN
AZ368557Medicaid