Provider Demographics
NPI:1952059750
Name:OMAR, ABAS HASSAN
Entity Type:Individual
Prefix:
First Name:ABAS
Middle Name:HASSAN
Last Name:OMAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 749074
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9074
Mailing Address - Country:US
Mailing Address - Phone:919-532-3700
Mailing Address - Fax:
Practice Address - Street 1:315 GREENVILLE BLVD SE STE 100
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5733
Practice Address - Country:US
Practice Address - Phone:252-917-5621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant