Individual
DR. ABDELRAHMAN M ABDALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
911 N SHELBY ST, SALEM, IN 47167-2304
(812) 896-0108
(812) 883-8556
Mailing address
911 N SHELBY ST, SALEM, IN 47167-2304
(812) 896-0108
(812) 883-8556
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01058910A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000342198
ANTHEM BLUE CROSS BLUE SHIELD
IN
01
—
01058910A
IN LICENSE
IN
05
—
200478450
—
IN
Enumeration date
05/01/2008
Last updated
05/01/2008
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