Provider Demographics
NPI:1871225276
Name:ABDULZAHRA, HAIDER (DNAP)
Entity Type:Individual
Prefix:
First Name:HAIDER
Middle Name:
Last Name:ABDULZAHRA
Suffix:
Gender:M
Credentials:DNAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6570 ROCKDALE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2544
Mailing Address - Country:US
Mailing Address - Phone:313-663-6660
Mailing Address - Fax:
Practice Address - Street 1:259 MACK AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2427
Practice Address - Country:US
Practice Address - Phone:313-577-1716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-26
Last Update Date:2022-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704314149163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse