Provider Demographics
NPI:1386946275
Name:BROOKS, W. ABDULLAH (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:W. ABDULLAH
Middle Name:
Last Name:BROOKS
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 HOUNDSWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-1067
Mailing Address - Country:US
Mailing Address - Phone:443-722-5511
Mailing Address - Fax:503-210-0453
Practice Address - Street 1:18 HOUNDSWOOD CT
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-1067
Practice Address - Country:US
Practice Address - Phone:443-722-5511
Practice Address - Fax:503-210-0453
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-26
Last Update Date:2010-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0046523208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics