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General NPI Number Information
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NPI Number | 1174116560
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Entity Type | Individual
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Provider Name | REDWAN KEDIR ABDO PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/16/2021
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 5141 CHAMBERS RD
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City | DENVER
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State | CO
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Zip | 80239-4231
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Country | US
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Telephone | 303-218-6237
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Fax |
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Provider Business Mailing Address
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Address Line | 8871 E FLORIDA AVE APT D13
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City | DENVER
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State | CO
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Zip | 80247-2829
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Country | US
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Telephone | 720-755-9238
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA.0023380
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License Number State | CO
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