Provider Demographics
NPI:1144391657
Name:ABADIER, WAHID JOHN (MD)
Entity Type:Individual
Prefix:
First Name:WAHID
Middle Name:JOHN
Last Name:ABADIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:576 FORT LOUDOUN MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-5676
Mailing Address - Country:US
Mailing Address - Phone:865-271-6565
Mailing Address - Fax:865-271-6566
Practice Address - Street 1:576 FORT LOUDOUN MEDICAL CENTER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37772-5676
Practice Address - Country:US
Practice Address - Phone:865-271-6566
Practice Address - Fax:865-271-6566
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI57752086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9004705Medicaid
TN1031027710Medicare PIN
RID87293Medicare UPIN