Provider Demographics
NPI:1750383493
Name:ABAZA, WAHIDA B (MD)
Entity type:Individual
Prefix:
First Name:WAHIDA
Middle Name:B
Last Name:ABAZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:CCP, LLC, DBA HAND IN HAND PEDIATRICS
Mailing Address - Street 2:6051 MEMORIAL DR
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-8218
Mailing Address - Country:US
Mailing Address - Phone:614-799-6044
Mailing Address - Fax:614-733-6088
Practice Address - Street 1:CCP, LLC, DBA HAND IN HAND PEDIATRICS
Practice Address - Street 2:6051 MEMORIAL DR
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017
Practice Address - Country:US
Practice Address - Phone:614-799-6044
Practice Address - Fax:614-799-6088
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35084625208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2518038Medicaid
OH06464OtherPARAMOUNT
OHI21012Medicare UPIN
OHAB4154991Medicare ID - Type Unspecified
OH2518038Medicaid
OH05227OtherPHC
MI4725150Medicaid
OH000000494802OtherANTHEM
OH7980606OtherAETNA