Healthcare Provider Details

I. General information

NPI: 1750777223
Provider Name (Legal Business Name): ABIDA KADI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2015
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4313 E COTTON CENTER BLVD STE 120
PHOENIX AZ
85040-8856
US

IV. Provider business mailing address

4313 E COTTON CENTER BLVD STE 120
PHOENIX AZ
85040-8856
US

V. Phone/Fax

Practice location:
  • Phone: 312-721-3526
  • Fax: 480-478-8095
Mailing address:
  • Phone: 312-721-3526
  • Fax: 480-478-8095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number312151
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number80978
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: