Basic Information
| Provider Information | |||||||||
| NPI: | 1598282600 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABUALRUZ | ||||||||
| FirstName: | ABDUL RAHMAN | ||||||||
| MiddleName: | MUSTAFA HASAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | AUGUSTA UNIVERSITY MEDICAL CENTER 1120 15TH STREET | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309120004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067286233 | ||||||||
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| Practice Location | |||||||||
| Address1: | AUGUSTA UNIVERSITY MEDICAL CENTER 1120 15TH STREET | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309120001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067218623 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2017 | ||||||||
| LastUpdateDate: | 07/07/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085B0100X | 89498 | GA | Y | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | 2085B0100X | 2020-00297 | NC | N | Allopathic & Osteopathic Physicians | Radiology | Body Imaging |
No ID Information.