Provider Demographics
NPI:1609054899
Name:DLEWATI, ABDALLAH (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDALLAH
Middle Name:
Last Name:DLEWATI
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 1:5040 VILLA LINDE PKWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3445
Mailing Address - Country:US
Mailing Address - Phone:810-230-0788
Mailing Address - Fax:
Practice Address - Street 1:5040 VILLA LINDE PKWY
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3445
Practice Address - Country:US
Practice Address - Phone:810-230-0788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-10
Last Update Date:2008-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301045812207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2851826Medicaid
MIE95572Medicare UPIN
MIOM25610002Medicare PIN