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General NPI Number Information
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NPI Number | 1376036970
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Entity Type | Individual
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Provider Name | ABDUL A DADA MD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2018
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 2231 TIMBER TRL
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-9036
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Country | US
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Telephone | 937-599-3115
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Fax |
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Provider Business Mailing Address
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Address Line | 205 E PALMER RD
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-2281
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Country | US
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Telephone | 937-592-4015
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 125.072954
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.143240
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License Number State | OH
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