Provider Demographics
NPI:1376036970
Name:DADA, ABDUL A (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:A
Last Name:DADA
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 1:1210 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2806
Mailing Address - Country:US
Mailing Address - Phone:740-454-0370
Mailing Address - Fax:
Practice Address - Street 1:1210 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2806
Practice Address - Country:US
Practice Address - Phone:740-454-0370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-08
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.143240207Q00000X
IL125.072954390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program