Mohammed Shayan Abdullah
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Philadelphia, PA
NPI 1013595495 · NPPES record last updated Apr 16, 2025
Key facts
- NPI
- 1013595495
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 3400 Spruce St
Philadelphia, PA 19104-4238 - Phone
- (215) 316-5151
- NPI assigned
- Mar 29, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD486138 | PA | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | MD486138 | PA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
3400 Spruce St
Philadelphia, PA 19104-4238
Mailing address
4701A Braeburn Dr
Bellaire, TX 77401-5311
Phone (281) 760-7181
Other providers in Philadelphia, PA
- Arifah Abdullah
- Kareemah Anjail Abdullah
- Karla Z Abdullah
- Madeel Ahmad Abdullah
- Malika Abdullah
- Natasha Abdullah
- Zafreen Abdullah
- Khadija A Abdullahi
- Amro Mohammed Abdulsattar
- Sultana Abdur Raheem
All providers in Philadelphia, PA · Student in an Organized Health Care Education/Training Program in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.