Basic Information
Provider Information
NPI: 1285953430
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABI HACHEM
FirstName: RALPH
MiddleName:  
NamePrefix:  
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Credential: MD
OtherOrganizationName:  
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Mailing Information
Address1: PO BOX 63362
Address2: ROOM 4034, OSU EYE AND EAR INSTITUTE
City: CHARLOTTE
State: NC
PostalCode: 282633362
CountryCode: US
TelephoneNumber: 8007826945
FaxNumber:  
Practice Location
Address1: 2301 ERWIN RD
Address2:  
City: DURHAM
State: NC
PostalCode: 277054699
CountryCode: US
TelephoneNumber: 9196848111
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/27/2010
LastUpdateDate: 11/09/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X FLN Student, Health CareStudent in an Organized Health Care Education/Training Program 
207Y00000X2016-01862NCY Allopathic & Osteopathic PhysiciansOtolaryngology 

No ID Information.


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