Healthcare Provider Details

I. General information

NPI: 1851132518
Provider Name (Legal Business Name): KADAN MD CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 KENYON AVE
WAKEFIELD RI
02879-4216
US

IV. Provider business mailing address

25 KEYES CT
EAST GREENWICH RI
02818-1450
US

V. Phone/Fax

Practice location:
  • Phone: 401-782-8000
  • Fax:
Mailing address:
  • Phone: 401-573-6960
  • Fax: 401-424-4531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ABDULLAH KADAN
Title or Position: OWNER
Credential: MD
Phone: 401-573-6960