Provider Demographics
NPI:1427235613
Name:ABOUYABIS, ABEER NITHAM
Entity type:Individual
Prefix:DR
First Name:ABEER
Middle Name:NITHAM
Last Name:ABOUYABIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2306 GARDEN PARK DR SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6309
Mailing Address - Country:US
Mailing Address - Phone:404-403-3884
Mailing Address - Fax:
Practice Address - Street 1:800 1ST ST
Practice Address - Street 2:SUITE 410
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-8300
Practice Address - Country:US
Practice Address - Phone:478-743-7068
Practice Address - Fax:478-741-1354
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055167174400000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA511507078CMedicaid
GA202I837964Medicare PIN