Provider Demographics
NPI:1043194681
Name:ABUNIJEM, LANA MAHMOUD
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:MAHMOUD
Last Name:ABUNIJEM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 ROSEBANK WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-2850
Mailing Address - Country:US
Mailing Address - Phone:864-359-9736
Mailing Address - Fax:
Practice Address - Street 1:214 ROSEBANK WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-2850
Practice Address - Country:US
Practice Address - Phone:864-359-9736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant