Provider Demographics
NPI:1780024273
Name:ABUQAYYAS, SAMI (MD)
Entity type:Individual
Prefix:
First Name:SAMI
Middle Name:
Last Name:ABUQAYYAS
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 1:112 HOSPITAL LN STE 303
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-1998
Mailing Address - Country:US
Mailing Address - Phone:131-771-8400
Mailing Address - Fax:317-718-4005
Practice Address - Street 1:112 HOSPITAL LN STE 303
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1998
Practice Address - Country:US
Practice Address - Phone:317-718-4000
Practice Address - Fax:317-718-4005
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01087264A207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine