Provider Demographics
NPI:1225005721
Name:ABADULLAH, AHMAD (MD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:ABADULLAH
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 1:4817 70TH AVE W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98467-3225
Mailing Address - Country:US
Mailing Address - Phone:253-565-8269
Mailing Address - Fax:
Practice Address - Street 1:4817 70TH AVE W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98467-3225
Practice Address - Country:US
Practice Address - Phone:253-565-8269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00035145208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA911503824OtherFIRST CHOICE HEALTH PLANS
WA911503824OtherTRICARE
WA911503824OtherAETNA INSURANCE
WA911503824OtherCIGNA INSURANCE
WA911503824OtherMOLINA HEALTH PLANS
WA91150382404OtherKITSAP HEALTH PLANS
WAP00199630OtherRAILROAD MEDICARE
WA911503824OtherUNIFORM MEDICAL PLAN
WA911503824OtherPREMERA
WA911503824OtherGROUP HEALTH
WA911503824OtherUNITED HEALTHCARE
WA014845OtherWA LABOR AND INDUSTRIES
WA4423ABOtherREGENCE BLUE SHIELD
WA8212763Medicaid
WA911503824OtherPRIVATE HEALTHCARE SYSTEM
WA911503824OtherPACIFICARE/SECURE HORIZON
WA911503824OtherFIRST HEALTH PLANS
WA911503824OtherCHOICE CARE
WA911503824OtherCIGNA INSURANCE
WA911503824OtherUNITED HEALTHCARE