Provider Demographics
NPI:1992811418
Name:ABBARAH, THABET R (MD)
Entity type:Individual
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First Name:THABET
Middle Name:R
Last Name:ABBARAH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 7257
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-7257
Mailing Address - Country:US
Mailing Address - Phone:248-681-3555
Mailing Address - Fax:248-681-9809
Practice Address - Street 1:4000 HIGHLAND RD
Practice Address - Street 2:SUITE 115
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-2167
Practice Address - Country:US
Practice Address - Phone:248-681-3555
Practice Address - Fax:248-681-9809
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2008-09-15
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Provider Licenses
StateLicense IDTaxonomies
MITA052508207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI10-2652878Medicaid
MI48282OtherOMNICARE HMO
MID99700OtherHEALTH ALLIANCE PLAN
MI006044OtherMIDWEST HEALTH PLAN
MI0406324371OtherBLUE CARE NETWORK
MI10-2699598Medicaid
MI605OtherHEALTH PLAN OF MI
MI0406324371OtherBLUE CROSS BLUE SHIELD MI
MI10-2738195Medicaid
MI103539OtherGREAT LAKE HEALTH PLAN
MIP57370001Medicare Oscar/Certification
MI605OtherHEALTH PLAN OF MI
MI10-2699598Medicaid