Provider Demographics
NPI:1316997489
Name:ABDULLA, MAHER A (MD)
Entity type:Individual
Prefix:
First Name:MAHER
Middle Name:A
Last Name:ABDULLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 OSIGIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-8953
Mailing Address - Country:US
Mailing Address - Phone:478-971-2130
Mailing Address - Fax:478-971-2132
Practice Address - Street 1:301 OSIGIAN BLVD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8953
Practice Address - Country:US
Practice Address - Phone:478-971-2130
Practice Address - Fax:478-971-2132
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA042151207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA85003047GMedicaid
GA11BDSQSMedicare ID - Type Unspecified
G34342Medicare UPIN