Provider Demographics
NPI:1699269886
Name:ABDELHAMID, HOUSAM
Entity type:Individual
Prefix:
First Name:HOUSAM
Middle Name:
Last Name:ABDELHAMID
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 1:6833 OLEANDER CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-8334
Mailing Address - Country:US
Mailing Address - Phone:513-344-8537
Mailing Address - Fax:
Practice Address - Street 1:11534 SPRINGFIELD PIKE
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:OH
Practice Address - Zip Code:45246-3516
Practice Address - Country:US
Practice Address - Phone:513-772-2777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03132348183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty