Provider Demographics
NPI:1972704427
Name:ALLABBAN, WASEEM (MD)
Entity type:Individual
Prefix:DR
First Name:WASEEM
Middle Name:
Last Name:ALLABBAN
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 1:7650 S MCCLINTOCK DR
Mailing Address - Street 2:SUITE# 103-378
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-1672
Mailing Address - Country:US
Mailing Address - Phone:480-568-6788
Mailing Address - Fax:480-568-6787
Practice Address - Street 1:5720 W CHANDLER BLVD
Practice Address - Street 2:SUITE# 3
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3359
Practice Address - Country:US
Practice Address - Phone:480-568-6788
Practice Address - Fax:480-568-6787
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125047338207R00000X
AZ37145207R00000X, 207RR0500X
KS0435828207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ242457-01Medicaid
AZZ116957Medicare PIN
AZ242457-01Medicaid