Provider Demographics
NPI:1578699807
Name:ABDOLKARIM, ADIB OMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ADIB
Middle Name:OMAR
Last Name:ABDOLKARIM
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 1:33000 PALMER RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186
Mailing Address - Country:US
Mailing Address - Phone:734-729-1800
Mailing Address - Fax:734-729-8030
Practice Address - Street 1:33000 PALMER RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186
Practice Address - Country:US
Practice Address - Phone:734-729-1800
Practice Address - Fax:734-729-8030
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301059759207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI417413310Medicaid
MI417413310Medicaid
OP30970Medicare ID - Type Unspecified