Individual
HATEM S ABDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19 FONTANA LN, STE 206, BALTIMORE, MD 21237-3047
(410) 391-6904
(410) 686-6640
Mailing address
301 SAINT PAUL PL, MEDICAL STAFF OFFICE, BALTIMORE, MD 21202-2102
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
D0019448
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408351200
—
MD
01
—
461P 894G
MEDICARE
MD
01
—
LK36 / 350598-02
BC / BS OF MD
MD
01
—
S186 / 0006
BLUECHOICE
MD
Enumeration date
06/09/2006
Last updated
01/14/2014
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