Provider Demographics
NPI:1669441846
Name:ABDULRAUF, ADEMOLA (MD)
Entity Type:Individual
Prefix:DR
First Name:ADEMOLA
Middle Name:
Last Name:ABDULRAUF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RAUF
Other - Middle Name:
Other - Last Name:ABDUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3701 LOOP ROAD EAST
Mailing Address - Street 2:3701 LOOP ROAD EAST
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404
Mailing Address - Country:US
Mailing Address - Phone:205-554-2000
Mailing Address - Fax:
Practice Address - Street 1:3701 LOOP RD
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5015
Practice Address - Country:US
Practice Address - Phone:205-554-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000243207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine