Provider Demographics
NPI:1598700320
Name:ABDEL-QADER, MURAD (DPM)
Entity Type:Individual
Prefix:
First Name:MURAD
Middle Name:
Last Name:ABDEL-QADER
Suffix:
Gender:M
Credentials:DPM
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 23959
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4490
Mailing Address - Country:US
Mailing Address - Phone:888-488-8289
Mailing Address - Fax:888-987-7129
Practice Address - Street 1:88 BRIGGS ST STE 170
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1295
Practice Address - Country:US
Practice Address - Phone:210-922-1551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005230213E00000X
TX1660213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01606583OtherBLUE CROSS BLUE SHIELD
IL016005230Medicaid
IL01634377OtherBLUE CROSS BLUE SHIELD
ILP00319146OtherRAILROAD MEDICARE
ILU97386Medicare UPIN
IL01606583OtherBLUE CROSS BLUE SHIELD
IL01634377OtherBLUE CROSS BLUE SHIELD
ILP00319146OtherRAILROAD MEDICARE