Healthcare Provider Details

I. General information

NPI: 1750554143
Provider Name (Legal Business Name): ADEGBOYEGA ABDULRAFIU ABDULKADIR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HALKET ST
PITTSBURGH PA
15213-3108
US

IV. Provider business mailing address

300 HALKET ST
PITTSBURGH PA
15213-3108
US

V. Phone/Fax

Practice location:
  • Phone: 412-641-4111
  • Fax: 412-641-5313
Mailing address:
  • Phone: 412-641-4111
  • Fax: 412-641-5313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD426880
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: