Provider Demographics
NPI:1598282600
Name:ABUALRUZ, ABDUL RAHMAN MUSTAFA HASAN (MD)
Entity Type:Individual
Prefix:
First Name:ABDUL RAHMAN
Middle Name:MUSTAFA HASAN
Last Name:ABUALRUZ
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:AUGUSTA UNIVERSITY MEDICAL CENTER 1120 15TH STREET
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0004
Mailing Address - Country:US
Mailing Address - Phone:706-728-6233
Mailing Address - Fax:
Practice Address - Street 1:AUGUSTA UNIVERSITY MEDICAL CENTER 1120 15TH STREET
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-0001
Practice Address - Country:US
Practice Address - Phone:706-721-8623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA894982085B0100X
NC2020-002972085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging