Provider Demographics
NPI:1881694370
Name:SADAT, ABDUL (MD)
Entity type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:
Last Name:SADAT
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 1:10931 RAVEN RIDGE RD
Mailing Address - Street 2:STE 115
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-6499
Mailing Address - Country:US
Mailing Address - Phone:919-676-0202
Mailing Address - Fax:919-676-0224
Practice Address - Street 1:10931 RAVEN RIDGE RD
Practice Address - Street 2:STE 115
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-6499
Practice Address - Country:US
Practice Address - Phone:919-676-0202
Practice Address - Fax:919-676-0224
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2008-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33888207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8974157Medicaid
NC74157OtherBCBS OF NC GROUP # 015CK
NCD1497OtherDR SADAT'S MEDCOST #
NC74157OtherBCBS OF NC GROUP # 015CK
NCA02761Medicare UPIN