Provider Demographics
NPI:1902313851
Name:ABUDAKER, ABDALLA
Entity Type:Individual
Prefix:
First Name:ABDALLA
Middle Name:
Last Name:ABUDAKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3462 MEADOWDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-6322
Mailing Address - Country:US
Mailing Address - Phone:804-803-2212
Mailing Address - Fax:
Practice Address - Street 1:3462 MEADOWDALE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23234-6322
Practice Address - Country:US
Practice Address - Phone:804-803-2212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-01
Last Update Date:2018-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)