Provider Demographics
NPI:1003652074
Name:UDDIN, ALBAB SYED
Entity type:Individual
Prefix:
First Name:ALBAB
Middle Name:SYED
Last Name:UDDIN
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 1:9636 LUEBCKE LN
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-6262
Mailing Address - Country:US
Mailing Address - Phone:219-741-5283
Mailing Address - Fax:
Practice Address - Street 1:9636 LUEBCKE LN
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-6262
Practice Address - Country:US
Practice Address - Phone:219-741-5283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN106006521499Medicaid