Provider Demographics
NPI:1740494657
Name:ABDELKADER, HESHAM HANFY (BACHELOR DEGREE)
Entity type:Individual
Prefix:
First Name:HESHAM
Middle Name:HANFY
Last Name:ABDELKADER
Suffix:
Gender:M
Credentials:BACHELOR DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1248 N IRISH RD
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-2213
Mailing Address - Country:US
Mailing Address - Phone:810-503-0986
Mailing Address - Fax:810-503-0990
Practice Address - Street 1:1248 N IRISH RD
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-2213
Practice Address - Country:US
Practice Address - Phone:810-503-0986
Practice Address - Fax:810-503-0990
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501006715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist