Provider Demographics
NPI:1013095041
Name:ABU BAKAR, INJIL (MD)
Entity Type:Individual
Prefix:
First Name:INJIL
Middle Name:
Last Name:ABU BAKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 VILLAGE GRN N STE 321
Mailing Address - Street 2:THE PINEHILLS
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-8803
Mailing Address - Country:US
Mailing Address - Phone:508-224-2224
Mailing Address - Fax:508-224-1778
Practice Address - Street 1:3 VILLAGE GRN N STE 321
Practice Address - Street 2:THE PINEHILLS
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-8803
Practice Address - Country:US
Practice Address - Phone:508-224-2224
Practice Address - Fax:508-224-1778
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA231258207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000042397OtherBMC HEALTH NET
MA496383OtherTUFTS HEALTH PLAN
MA2134861Medicaid
MA7076936OtherAETNA
MAAA92185OtherHARVARD PILGRIM
MAJ41906OtherBCBSMA
MA2134861Medicaid