Provider Demographics
NPI:1881469500
Name:KIMO, ABDULHAMID H (ABDULHAMID)
Entity type:Individual
Prefix:
First Name:ABDULHAMID
Middle Name:H
Last Name:KIMO
Suffix:
Gender:M
Credentials:ABDULHAMID
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3907 BOGDON DR # 43110
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8143
Mailing Address - Country:US
Mailing Address - Phone:702-927-5553
Mailing Address - Fax:
Practice Address - Street 1:3907 BOGDON DR # 43110
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-8143
Practice Address - Country:US
Practice Address - Phone:702-927-5553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical