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Organization

WASHINGTON COUNTY MEMORIAL HOSPITAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ABDELRAHMAN M ABDALLA M.D. (RADIOLOGIST)
(812) 883-5881
Entity
Organization

Contact information

Practice address
125 SPRING MEADOW CIR, SALEM, IN 47167-9429
(812) 883-3963
Mailing address
125 SPRING MEADOW CIR, SALEM, IN 47167-9429
(812) 883-3963

Taxonomy

Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
01058910A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000342198
BLUE CROSS BLUE SHIELDS
IN
01
01058910A
STATE LICENSE
IN
01
203299
COMMERCIAL ID
IN
Enumeration date
12/12/2006
Last updated
03/07/2023
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