Provider Demographics
NPI:1285167965
Name:JAWAD, ABDULLAH (MD)
Entity type:Individual
Prefix:MR
First Name:ABDULLAH
Middle Name:
Last Name:JAWAD
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 1:7105 WAREHAM DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1129
Mailing Address - Country:US
Mailing Address - Phone:813-451-4177
Mailing Address - Fax:
Practice Address - Street 1:108 LEGION DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4893
Practice Address - Country:US
Practice Address - Phone:505-426-3749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63883390200000X
NMMD2024-1291208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program