Provider Demographics
NPI:1548750813
Name:ABDALLAH, HOSAM AHMAD DIAB (MD)
Entity Type:Individual
Prefix:
First Name:HOSAM
Middle Name:AHMAD DIAB
Last Name:ABDALLAH
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 1:401 LINDEN AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-1729
Mailing Address - Country:US
Mailing Address - Phone:973-493-3033
Mailing Address - Fax:
Practice Address - Street 1:7703 FLOYD CURL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3901
Practice Address - Country:US
Practice Address - Phone:176-721-0567
Practice Address - Fax:210-567-4712
Is Sole Proprietor?:No
Enumeration Date:2018-05-13
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEMD22583207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine