Provider Demographics
NPI:1821267477
Name:ABBAS, SYED (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:
Last Name:ABBAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4224 PURPLE TWILIGHT WAY
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-5954
Mailing Address - Country:US
Mailing Address - Phone:240-938-9684
Mailing Address - Fax:
Practice Address - Street 1:6701 N CHARLES ST
Practice Address - Street 2:SUITE 4105
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:443-849-3184
Practice Address - Fax:443-849-3182
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD72139207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD712L/225560YBPGMedicare PIN