MEDICARE: DR. ABDALLAH N ADHAM 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
1	207R00000X	Internal Medicine Physician	F0848	TX

General Provider Information

NPI Number	:	1275631921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABDALLAH N ADHAM MD

Provider Business Mailing Address
First Line	:	3946 SOUTH BUCKNER
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75227
Country	:	US
Telephone Number	:	214-388-8181
Fax Number	:	214-388-0141

Provider Business Practice Location Address
First Line	:	3946 SOUTH BUCKNER
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75227
Country	:	US
Telephone Number	:	214-388-8181
Fax Number	:	214-388-0141

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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