Provider Demographics
NPI:1952478620
Name:ALWAHDANI, ABDULLAH A (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDULLAH
Middle Name:A
Last Name:ALWAHDANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:MERCY CARDIOLOGY CLINIC
Mailing Address - Street 2:788 8TH AVENUE SE, SUITE 400
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401
Mailing Address - Country:US
Mailing Address - Phone:319-832-2328
Mailing Address - Fax:319-832-1168
Practice Address - Street 1:MERCY CARDIOLOGY CLINIC
Practice Address - Street 2:788 8TH AVENUE SE, SUITE 400
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401
Practice Address - Country:US
Practice Address - Phone:319-832-2328
Practice Address - Fax:319-832-1168
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA36118207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA71960OtherMEDICARE GROUP