ABDEL-AZEZ OMAR ABDEL AZIZ ABU-SAMAK MBBS
NPI 1053984989
Student in an Organized Health Care Education/Training Program in Detroit, MI

Q: What is Abdel-azez Abu-samak's NPI number?

The NPI number for Abdel-azez Abu-samak is 1053984989. It was assigned to this individual provider in the NPPES registry on July 19, 2021.

Q: What is Abdel-azez Abu-samak's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since July 19, 2021PECOS Enrolled

2800 W GRAND BLVD, DETROIT, MI 48202(888) 777-4167 Get Directions Write a Review

NPPES record last updated: July 25, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 25, 2024, Jul 20, 2021 (2 updates tracked since 2021).

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About Abdel-azez Omar Abdel Aziz Abu-samak Mbbs NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ABDEL-AZEZ OMAR ABDEL AZIZ ABU-SAMAK MBBS (NPI 1053984989) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since July 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053984989

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameABDEL-AZEZ OMAR ABDEL AZIZ ABU-SAMAKCredential: MBBS

Location Address2800 W GRAND BLVDDetroit, MI 48202-2610

Mailing Address2800 W Grand Blvd Fl 6Detroit, MI 48202-2610 · (908) 737-2573

Phone(888) 777-4167

Sole ProprietorNo

Enumeration DateJuly 19, 2021

Last NPPES UpdateJuly 25, 20242 updates tracked since enumeration

NPPES CertifiedJuly 25, 2024

✔ NPI 1053984989 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2800 W GRAND BLVD, Detroit, MI 48202

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Abdel-azez Omar Abdel Aziz Abu-samak Mbbs is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. IRINA BOBEICA NP

Nurse Practitioner (Primary Care)