Provider Demographics
NPI:1750429130
Name:AZIZ, ABDULRAB (MD)
Entity type:Individual
Prefix:DR
First Name:ABDULRAB
Middle Name:
Last Name:AZIZ
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 1:125 DAUGHERTY DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2749
Mailing Address - Country:US
Mailing Address - Phone:412-856-4666
Mailing Address - Fax:412-856-6907
Practice Address - Street 1:125 DAUGHERTY DR
Practice Address - Street 2:SUITE 301
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2749
Practice Address - Country:US
Practice Address - Phone:412-856-4666
Practice Address - Fax:412-856-6907
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038536L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA009876100009Medicaid
PA417897MV2Medicare ID - Type Unspecified
PA009876100009Medicaid