Provider Demographics
NPI:1194541094
Name:ABDEL-HAK, SAMIR
Entity type:Individual
Prefix:
First Name:SAMIR
Middle Name:
Last Name:ABDEL-HAK
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 1:45762 PRAIRIEGRASS CT
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48111-6429
Mailing Address - Country:US
Mailing Address - Phone:313-287-6236
Mailing Address - Fax:
Practice Address - Street 1:45762 PRAIRIEGRASS CT
Practice Address - Street 2:
Practice Address - City:VAN BUREN TWP
Practice Address - State:MI
Practice Address - Zip Code:48111-6429
Practice Address - Country:US
Practice Address - Phone:313-287-6236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704348570163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency