Provider Demographics
NPI:1104255439
Name:ELHALAWANY, ABDALLA M
Entity type:Individual
Prefix:
First Name:ABDALLA
Middle Name:M
Last Name:ELHALAWANY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ZELKOVA CT NW
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-9377
Mailing Address - Country:US
Mailing Address - Phone:828-464-4700
Mailing Address - Fax:
Practice Address - Street 1:201 ZELKOVA CT NW
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-9377
Practice Address - Country:US
Practice Address - Phone:828-464-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2014-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23838183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist