Individual
ABDALAGANI A. BAHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-0411
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 244-5964
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01061927A
IN
207RN0300X
Nephrology Physician
Primary
ME123518
FL
208M00000X
Hospitalist Physician
01061927
IN
208M00000X
Hospitalist Physician
ME123518
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000491497
ANTHEM
IN
05
—
200837130
—
IN
01
—
20543
PHP
IN
01
—
3937240010
MEDICARE DMEPOS
IN
01
—
P00364911
RAILROAD MEDICARE
IN
Enumeration date
07/14/2006
Last updated
07/01/2025
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