MEDICARE: ABIDA KADI M.D.

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
2	207ZD0900X	Dermatopathology (Pathology) Physician	312151	LA
3	207ZD0900X	Dermatopathology (Pathology) Physician	80978	AZ

General Provider Information

NPI Number	:	1750777223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIDA KADI M.D.

Provider Business Mailing Address
First Line	:	4313 E COTTON CENTER BLVD STE 120
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-8856
Country	:	US
Telephone Number	:	312-721-3526
Fax Number	:	480-478-8095

Provider Business Practice Location Address
First Line	:	4313 E COTTON CENTER BLVD STE 120
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-8856
Country	:	US
Telephone Number	:	312-721-3526
Fax Number	:	480-478-8095

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

Provider Enumeration Date	:	04/12/2015
Last Update Date	:	05/21/2026

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