Provider Demographics
NPI:1801381389
Name:AL HOUT, ABDUL RAHMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDUL RAHMAN
Middle Name:
Last Name:AL HOUT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 SANDERSON RD
Mailing Address - Street 2:STE 206
Mailing Address - City:SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02917-2603
Mailing Address - Country:US
Mailing Address - Phone:330-480-3605
Mailing Address - Fax:
Practice Address - Street 1:1053 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1007
Practice Address - Country:US
Practice Address - Phone:330-480-3605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD17768207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty