Provider Demographics
NPI:1699020677
Name:ABBAS, HAWAZIN KUDDIAR (MD)
Entity Type:Individual
Prefix:
First Name:HAWAZIN
Middle Name:KUDDIAR
Last Name:ABBAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 CROSS CREEK PKWY STE 210B
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2776
Mailing Address - Country:US
Mailing Address - Phone:248-335-1110
Mailing Address - Fax:248-335-6129
Practice Address - Street 1:3100 CROSS CREEK PKWY STE 210B
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2776
Practice Address - Country:US
Practice Address - Phone:248-335-1110
Practice Address - Fax:248-335-6129
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME144941207R00000X, 207RC0200X, 207RP1001X, 207RS0012X
MI4301101688207RS0012X, 207RP1001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106451200Medicaid