Provider Demographics
NPI:1164473377
Name:ATTUM, ABDULLA A (MD)
Entity Type:Individual
Prefix:
First Name:ABDULLA
Middle Name:A
Last Name:ATTUM
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:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-0432
Mailing Address - Country:US
Mailing Address - Phone:606-430-2201
Mailing Address - Fax:606-218-4651
Practice Address - Street 1:911 BYPASS RD BLDG A
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1689
Practice Address - Country:US
Practice Address - Phone:606-430-2201
Practice Address - Fax:606-218-4651
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20383208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
2802445000OtherPAD - CTS
50013454OtherPASSPORT - CTS
000000497075OtherANTHEM - CTS
IN200081180Medicaid
KYP00368245OtherRRMCR - CTS
081347OtherSIHO - CTS
KY64203839Medicaid
KY0998823Medicare PIN
IN196290XXXMedicare PIN
C69688Medicare UPIN
KYK124914Medicare PIN