Provider Demographics
NPI:1689638918
Name:ABDELHAMID, YASER (ND AND LAC)
Entity Type:Individual
Prefix:DR
First Name:YASER
Middle Name:
Last Name:ABDELHAMID
Suffix:
Gender:M
Credentials:ND AND LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29463 DETROIT RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1930
Mailing Address - Country:US
Mailing Address - Phone:440-212-0046
Mailing Address - Fax:
Practice Address - Street 1:730 SOM CENTER RD
Practice Address - Street 2:190
Practice Address - City:MAYFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44143-2350
Practice Address - Country:US
Practice Address - Phone:440-995-0303
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH67171100000X
VT147175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered175F00000XOther Service ProvidersNaturopath