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NPI Code Detail

MEDICARE: ABDULLAH A BAOSMAN DO

MEDICARE: ABDULLAH A BAOSMAN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207R00000XInternal Medicine Physician13701GA
3208M00000XHospitalist Physician94693SC

General Provider Information

NPI Number : 1508507807
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABDULLAH A BAOSMAN DO
Provider Business Mailing Address
First Line : 1230 BAXTER ST
Second Line :
City : ATHENS
State : GA
Zip : 30606-3712
Country : US
Telephone Number : 706-389-3860
Fax Number : 706-389-3861
Provider Business Practice Location Address
First Line : 2720 SUNSET BLVD
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29169-4810
Country : US
Telephone Number : 803-936-7372
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2022
Last Update Date : 03/18/2026

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