Provider Demographics
NPI:1750546750
Name:ABDULLAH, VICTOR
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:ABDULLAH
Suffix:
Gender:M
Credentials:
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 280563
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-0563
Mailing Address - Country:US
Mailing Address - Phone:615-573-6995
Mailing Address - Fax:615-254-6945
Practice Address - Street 1:3620 BUENA VISTA PIKE
Practice Address - Street 2:SUITE D
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37218-2000
Practice Address - Country:US
Practice Address - Phone:615-573-5177
Practice Address - Fax:615-254-6945
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-20
Last Update Date:2008-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN020081110343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)