Provider Demographics
NPI:1629550611
Name:ABD ALRAHEAM, ISLAM
Entity Type:Individual
Prefix:DR
First Name:ISLAM
Middle Name:
Last Name:ABD ALRAHEAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 BRAUER HALL CB #7450 CHAPEL HILL NC 27599-7450
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7450
Mailing Address - Country:US
Mailing Address - Phone:919-945-6975
Mailing Address - Fax:919-537-3990
Practice Address - Street 1:436 BRAUER HALL CB #7450 CHAPEL HILL NC 27599-7450
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-945-6975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC151071122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist