MEDICARE: MEHBOOB GULAMALI ABDULLAH DDS

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
1	390200000X	Student in an Organized Health Care Education/Training Program		OH
2	1223G0001X	General Practice Dentistry	30.023108	OH

General Provider Information

NPI Number	:	1184899692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEHBOOB GULAMALI ABDULLAH DDS

Provider Business Mailing Address
First Line	:	2500 METROHEALTH DRIVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-1998
Country	:	US
Telephone Number	:	216-778-4737
Fax Number	:	216-778-8875

Provider Business Practice Location Address
First Line	:	2500 METROHEALTH DRIVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-1998
Country	:	US
Telephone Number	:	216-778-4737
Fax Number	:	216-778-8875

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2008
Last Update Date	:	06/14/2022

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