Provider Demographics
NPI:1801481650
Name:ABDU, REDWAN MOHAMMED SR
Entity type:Individual
Prefix:
First Name:REDWAN
Middle Name:MOHAMMED
Last Name:ABDU
Suffix:SR
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 1:723 CAMPBELL WAY
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-5444
Mailing Address - Country:US
Mailing Address - Phone:571-484-3818
Mailing Address - Fax:
Practice Address - Street 1:723 CAMPBELL WAY
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-5444
Practice Address - Country:US
Practice Address - Phone:571-484-3818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)