Provider Demographics
NPI:1578091641
Name:ABDOU, ASRAR (MD)
Entity Type:Individual
Prefix:
First Name:ASRAR
Middle Name:
Last Name:ABDOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 ORLEANS ST APT 315
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-2969
Mailing Address - Country:US
Mailing Address - Phone:956-313-1575
Mailing Address - Fax:
Practice Address - Street 1:4201 SAINT ANTOINE ST # ST9C
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-2153
Practice Address - Country:US
Practice Address - Phone:313-993-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program