Provider Demographics
NPI:1649753096
Name:HARAAARE, ABDIAZIZ M
Entity Type:Individual
Prefix:
First Name:ABDIAZIZ
Middle Name:M
Last Name:HARAAARE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 TIMBERLAKE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-1537
Mailing Address - Country:US
Mailing Address - Phone:937-829-1221
Mailing Address - Fax:937-387-9511
Practice Address - Street 1:309 TIMBERLAKE DR
Practice Address - Street 2:
Practice Address - City:DATYON
Practice Address - State:OH
Practice Address - Zip Code:45414-4541
Practice Address - Country:US
Practice Address - Phone:937-829-1221
Practice Address - Fax:937-387-9511
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)