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NPI Code Detail

MEDICARE: ABDULLA M ABDULLA MD

MEDICARE: ABDULLA M ABDULLA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician017117GA

General Provider Information

NPI Number : 1174502694
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABDULLA M ABDULLA MD
Provider Business Mailing Address
First Line : 1348 WALTON WAY
Second Line : SUITE 5100
City : AUGUSTA
State : GA
Zip : 30901-5108
Country : US
Telephone Number : 706-724-8611
Fax Number : 706-821-8100
Provider Business Practice Location Address
First Line : 1348 WALTON WAY
Second Line : SUITE 5100
City : AUGUSTA
State : GA
Zip : 30901-5108
Country : US
Telephone Number : 706-724-8611
Fax Number : 706-821-8100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2006
Last Update Date : 05/02/2008

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Directions to “ ABDULLA M ABDULLA MD” Practice Location

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