Provider Demographics
NPI:1275659823
Name:ABDULAI M. BUKARI MD, PC.
Entity type:Organization
Organization Name:ABDULAI M. BUKARI MD, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUKAYATU
Authorized Official - Middle Name:
Authorized Official - Last Name:BUKARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-232-0500
Mailing Address - Street 1:1928 CHRISTOPHER PL
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-3576
Mailing Address - Country:US
Mailing Address - Phone:717-232-0500
Mailing Address - Fax:717-232-8973
Practice Address - Street 1:891 S ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5004
Practice Address - Country:US
Practice Address - Phone:717-232-0500
Practice Address - Fax:717-232-8973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016393990004Medicaid
PAMD058766LOtherSTATE LICENSE
PA0016393990004Medicaid
149189Medicare ID - Type Unspecified