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General NPI Number Information
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NPI Number | 1467718049
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Entity Type | Individual
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Provider Name | FATEN ABDULLAH M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/08/2012
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Last Update Date | 12/09/2020
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Provider Practice Location Address
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Address Line | 720 W HILL ST
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City | LOUISVILLE
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State | KY
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Zip | 40208-2216
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Country | US
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Telephone | 502-636-3164
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Fax | 502-634-3731
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Provider Business Mailing Address
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Address Line | 5200 COMMERCE CROSSINGS DR
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City | LOUISVILLE
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State | KY
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Zip | 40229-2182
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Country | US
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Telephone | 502-253-4977
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Fax | 502-489-5751
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 47864
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License Number State | KY
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