Provider Demographics
NPI:1922085851
Name:HAFEEZ, ABDUL (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:
Last Name:HAFEEZ
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 1:164 W 13TH STREET
Mailing Address - Street 2:UNITY MEDICAL CENTER
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-1896
Mailing Address - Country:US
Mailing Address - Phone:701-352-1620
Mailing Address - Fax:701-352-1671
Practice Address - Street 1:164 W 13TH STREET
Practice Address - Street 2:UNITY MEDICAL CENTER
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-1896
Practice Address - Country:US
Practice Address - Phone:701-352-1620
Practice Address - Fax:701-352-1671
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-30
Last Update Date:2007-07-08
Deactivation Date:2006-01-11
Deactivation Code:
Reactivation Date:2007-03-26
Provider Licenses
StateLicense IDTaxonomies
ND3535207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12825Medicaid
D25930Medicare UPIN
606Medicare ID - Type Unspecified