Provider Demographics
NPI:1831127562
Name:ABBASI, JAVAID (DO)
Entity Type:Individual
Prefix:DR
First Name:JAVAID
Middle Name:
Last Name:ABBASI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1406
Mailing Address - Country:US
Mailing Address - Phone:515-241-6262
Mailing Address - Fax:
Practice Address - Street 1:1200 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1406
Practice Address - Country:US
Practice Address - Phone:515-241-6262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02922207P00000X
WI48211207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA4122580Medicaid
WI35132000Medicaid
IA5122580Medicaid
IA1831127562Medicaid
WIP00663031OtherMEDICARE RAILROAD
IA080086339OtherRAILROAD MEDICARE
IAIB1436037Medicare PIN
IA54704Medicare PIN
IA080086339OtherRAILROAD MEDICARE
IA4122580Medicaid
IA1831127562Medicaid
IA54690Medicare PIN
WI0134Medicare PIN