Healthcare Provider Details

I. General information

NPI: 1124757828
Provider Name (Legal Business Name): BAHAA ABDELQADER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MOBILE INFIRMARY CIR
MOBILE AL
36607-3513
US

IV. Provider business mailing address

5 MOBILE INFIRMARY CIR
MOBILE AL
36607-3513
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-7261
  • Fax: 251-435-7282
Mailing address:
  • Phone: 251-435-7261
  • Fax: 251-435-7282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO.4234
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: