Individual
BABA ABUDU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 W 4TH ST, COFFEYVILLE, KS 67337-3306
(620) 251-1200
Mailing address
PO BOX 787, COFFEYVILLE, KS 67337-0787
(316) 685-8428
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
04-22583
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057965
BCBS
KS
05
—
10115630B
—
KS
Enumeration date
01/08/2007
Last updated
07/08/2007
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