Provider Demographics
NPI:1568481182
Name:ABBAS, SAMER (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMER
Middle Name:
Last Name:ABBAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4320 FIR ST
Mailing Address - Street 2:STE 320
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-3076
Mailing Address - Country:US
Mailing Address - Phone:219-554-4080
Mailing Address - Fax:219-554-4085
Practice Address - Street 1:4320 FIR ST
Practice Address - Street 2:STE 320
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-3076
Practice Address - Country:US
Practice Address - Phone:219-554-4080
Practice Address - Fax:219-554-4085
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01066286A207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOI23321Medicare UPIN
ILK22800Medicare ID - Type Unspecified