Provider Demographics
NPI:1124900931
Name:AL BOUJAWARI, SADDAM
Entity type:Individual
Prefix:
First Name:SADDAM
Middle Name:
Last Name:AL BOUJAWARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5976 HASWELL PL
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-5870
Mailing Address - Country:US
Mailing Address - Phone:402-601-2191
Mailing Address - Fax:
Practice Address - Street 1:5976 HASWELL PL
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-5870
Practice Address - Country:US
Practice Address - Phone:402-601-2191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health