Provider Demographics
NPI:1881103927
Name:ABDELJABER, REFAT HASAN (DC)
Entity type:Individual
Prefix:DR
First Name:REFAT
Middle Name:HASAN
Last Name:ABDELJABER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 N 51ST AVE STE 118
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85031-1943
Mailing Address - Country:US
Mailing Address - Phone:602-800-9111
Mailing Address - Fax:
Practice Address - Street 1:4105 N 51ST AVE STE 118
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-1943
Practice Address - Country:US
Practice Address - Phone:602-800-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8595111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor