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General NPI Number Information
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NPI Number | 1962964031
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Entity Type | Individual
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Provider Name | ABDALLA ISMAIL MD
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Gender | Male
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Dates
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Enumeration Date | 04/05/2019
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 4650 HILLS AND DALES RD NW
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City | CANTON
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State | OH
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Zip | 44708-6220
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Country | US
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Telephone | 330-649-9400
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Fax | 330-491-2410
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Provider Business Mailing Address
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Address Line | 2600 SIXTH ST SW
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City | CANTON
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State | OH
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Zip | 44710-1799
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Country | US
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Telephone | 330-363-6223
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Fax | 330-363-3877
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 35.144895
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License Number State | OH
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