Individual provider · NPI-1

Mariam Abdul-Hussein Abbas

Nurse Practitioner, Gerontology · Southgate, MI

NPI number1982352811
StatusActive
Last updated in NPPESMar 10, 2022

Details

NPI
1982352811
Entity type
Individual (NPI-1)
Name
Mariam Abdul-Hussein Abbas
Sex
Female
Sole proprietor
No
Enumeration date
Mar 10, 2022
Certification date
Mar 8, 2022
Last updated
Mar 10, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LG0600X Nurse Practitioner, Gerontology4704286635MIYes

Practice location

14799 Dix Toledo Rd
Southgate, MI 48195-2507

Phone 734-324-8326

Mailing address

732 Dover St
Dearborn Heights, MI 48127-4114

Phone 313-671-8961

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