Provider Demographics
NPI:1083692412
Name:OZ, ABDULLAH (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDULLAH
Middle Name:
Last Name:OZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10827 NE 108TH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5033
Mailing Address - Country:US
Mailing Address - Phone:425-286-6494
Mailing Address - Fax:425-286-6494
Practice Address - Street 1:24230 18TH PL W
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-9283
Practice Address - Country:US
Practice Address - Phone:425-286-6494
Practice Address - Fax:425-286-6494
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60162698208M00000X
WA208180207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2144883Medicaid
OH2314310Medicaid
MA2144883Medicaid
OHOZ4103271Medicare ID - Type Unspecified