Individual provider · NPI-1

Mohammad Abdallat, MD

Thoracic Surgery (Cardiothoracic Vascular Surgery) · Providence, RI

NPI number1033634647
StatusActive
Last updated in NPPESMar 18, 2026

Details

NPI
1033634647
Entity type
Individual (NPI-1)
Name
Mohammad Abdallat
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Aug 4, 2017
Certification date
Mar 18, 2026
Last updated
Mar 18, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)CMD20274RIYes
208600000X SurgeryCMD20274RI

Practice location

50 Maude St
Providence, RI 02908-4325

Phone 401-456-2077

Mailing address

825 Chalkstone Ave
Providence, RI 02908-4728

Phone 929-217-7323

Other practice locations

825 Chalkstone Ave
Providence, RI 02908-4728

Phone 929-217-7323

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