Provider Demographics
NPI:1568049245
Name:ELEMAM, ABUBAKER KHALAFALLA MOHAMED (MBBS)
Entity Type:Individual
Prefix:DR
First Name:ABUBAKER
Middle Name:KHALAFALLA MOHAMED
Last Name:ELEMAM
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC STREET BOX 357115
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-0001
Mailing Address - Country:US
Mailing Address - Phone:206-598-2094
Mailing Address - Fax:206-543-6317
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-2059
Practice Address - Country:US
Practice Address - Phone:206-598-2094
Practice Address - Fax:206-543-6317
Is Sole Proprietor?:No
Enumeration Date:2021-03-27
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program