Individual provider · NPI-1

Mohamed A Abdulla, MD

Pathology, Anatomic Pathology & Clinical Pathology · Wilkes Barre, PA

NPI number1700820487
StatusActive
Last updated in NPPESDec 7, 2022

Details

NPI
1700820487
Entity type
Individual (NPI-1)
Name
Mohamed A Abdulla
Credential
MD
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 15, 2006
Certification date
Dec 7, 2022
Last updated
Dec 7, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207ZP0102X Pathology, Anatomic Pathology & Clinical PathologyMD047282LPAYes
207ZC0500X Pathology, CytopathologyMD047282LPA
207ZP0101X Pathology, Anatomic Pathology25MA07827100NJ
291U00000X Clinical Medical Laboratory232717-1NY

Practice location

575 N River St
Wilkes Barre, PA 18702-2634

Phone 570-552-1435 · Fax 570-552-1510

Mailing address

Po Box 1476
Kingston, PA 18704-0476

Phone 570-288-8881 · Fax 570-288-8065

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