=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124757828
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BAHAA ABDELQADER DO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2022
-----------------------------------------------------
Last Update Date | 09/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5 MOBILE INFIRMARY CIR
-----------------------------------------------------
City | MOBILE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36607-3513
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 251-435-7261
-----------------------------------------------------
Fax | 251-435-7282
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5 MOBILE INFIRMARY CIR
-----------------------------------------------------
City | MOBILE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36607-3513
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 251-435-7261
-----------------------------------------------------
Fax | 251-435-7282
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | DO.4234
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------