Provider Demographics
NPI:1861931941
Name:ABOUARABI, WASSIM (NP)
Entity type:Individual
Prefix:MR
First Name:WASSIM
Middle Name:
Last Name:ABOUARABI
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 VALLEY VIEW LN STE 400
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-5071
Mailing Address - Country:US
Mailing Address - Phone:972-715-3800
Mailing Address - Fax:
Practice Address - Street 1:4700 SCHAEFER RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3655
Practice Address - Country:US
Practice Address - Phone:313-581-2600
Practice Address - Fax:313-581-2600
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704300234363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily