Provider Demographics
NPI:1972575298
Name:ABUHAMAD, GHASSAN (MD)
Entity Type:Individual
Prefix:
First Name:GHASSAN
Middle Name:
Last Name:ABUHAMAD
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-6454
Mailing Address - Fax:717-851-1665
Practice Address - Street 1:3 RICHLAND MEDICAL PARK DR STE 330
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6862
Practice Address - Country:US
Practice Address - Phone:803-434-7100
Practice Address - Fax:803-434-6889
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD423676208600000X, 2086S0129X
SC878452086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101362464Medicaid
OH2595991Medicaid
PAP01326713Medicare PIN
PAF07177Medicare UPIN
PA092173PNLMedicare PIN