Provider Demographics
NPI:1982833133
Name:KADAN, ABDULLAH (MD)
Entity Type:Individual
Prefix:
First Name:ABDULLAH
Middle Name:
Last Name:KADAN
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 1:4510 DORR ST # MS 840
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-4040
Mailing Address - Country:US
Mailing Address - Phone:419-383-3455
Mailing Address - Fax:419-383-2021
Practice Address - Street 1:3000 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2598
Practice Address - Country:US
Practice Address - Phone:419-383-3455
Practice Address - Fax:419-383-2021
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15612208M00000X
OH57.246458390200000X
OH35.139316207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1982833133Medicaid
NH3075591Medicaid
NH3075591Medicaid