Healthcare Provider Details

I. General information

NPI: 1235972779
Provider Name (Legal Business Name): ABDEL TOURE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 CONSTITUTION DR
CINCINNATI OH
45215-5328
US

IV. Provider business mailing address

8501 CONSTITUTION DR
CINCINNATI OH
45215-5328
US

V. Phone/Fax

Practice location:
  • Phone: 513-290-0131
  • Fax:
Mailing address:
  • Phone: 513-290-0131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberKGX5765
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: