Individual
FATEN ABDULLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
720 W HILL ST, LOUISVILLE, KY 40208-2216
(502) 636-3164
(502) 634-3731
Mailing address
5200 COMMERCE CROSSINGS DR, LOUISVILLE, KY 40229-2182
(502) 253-4977
(502) 489-5751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47864
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000931450
ANTHEM - NICC
KY
01
—
177876
SIHO - NICC
KY
01
—
50090549
PASSPORT - NICC
KY
05
—
7100352410
—
KY
Enumeration date
04/08/2012
Last updated
12/09/2020
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