Individual provider · NPI-1

Siraj F. Abdullah, D.O.

Family Medicine, Sports Medicine · Columbia, SC

NPI number1235450685
StatusActive
Last updated in NPPESFeb 24, 2015

Details

NPI
1235450685
Entity type
Individual (NPI-1)
Name
Siraj F. Abdullah
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
Jun 21, 2010
Last updated
Feb 24, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207QS0010X Family Medicine, Sports Medicine1396SCYes
207Q00000X Family Medicine1396SC

Practice location

3209 Colonial Drive
Family Medicine Center
Columbia, SC 29203-6809

Phone 803-434-6116 · Fax 803-434-8478

Mailing address

3209 Colonial Drive
Family Medicine Center
Columbia, SC 29203-6894

Phone 803-434-6113 · Fax 803-434-7231

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