1801682422 NPI number — ABDALLAH BASHAR ABDALLAH SAMMAN

Table of content: ABDALLAH BASHAR ABDALLAH SAMMAN (NPI 1801682422)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801682422 NPI number — ABDALLAH BASHAR ABDALLAH SAMMAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAMMAN
Provider First Name:
ABDALLAH
Provider Middle Name:
BASHAR ABDALLAH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801682422
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21, AL-HARETH BEN OMEIR ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMMAN
Provider Business Mailing Address State Name:
JORDAN
Provider Business Mailing Address Postal Code:
11118
Provider Business Mailing Address Country Code:
JO
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
37595 SEVEN MILE RD, SUITE 340 LIVONIA, MI 48152, TRINI
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVONIA
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48152
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-793-2470
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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