Provider Demographics
NPI:1881896223
Name:ABOUFAKHER, RABEEA (MD)
Entity type:Individual
Prefix:DR
First Name:RABEEA
Middle Name:
Last Name:ABOUFAKHER
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 1:2401 DEMERS AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201
Mailing Address - Country:US
Mailing Address - Phone:701-780-1891
Mailing Address - Fax:701-780-1942
Practice Address - Street 1:1300 S COLUMBIA RD - ALTRU 1300 COLUMBIA
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:85201-4012
Practice Address - Country:US
Practice Address - Phone:701-780-2300
Practice Address - Fax:701-780-1942
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301077144207RC0000X, 207RG0300X
ND11136207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine