Provider Demographics
NPI:1487752093
Name:ZANABLI, ABDUL RAHMAN (MD)
Entity type:Individual
Prefix:
First Name:ABDUL
Middle Name:RAHMAN
Last Name:ZANABLI
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 1:500 POPLAR ST STE 203
Mailing Address - Street 2:
Mailing Address - City:S CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1472
Mailing Address - Country:US
Mailing Address - Phone:304-414-2850
Mailing Address - Fax:304-414-2859
Practice Address - Street 1:500 POPLAR ST STE 203
Practice Address - Street 2:
Practice Address - City:S CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1472
Practice Address - Country:US
Practice Address - Phone:304-414-2850
Practice Address - Fax:304-414-2859
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46320207R00000X
WV22697207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810009213Medicaid
WV001953136OtherBC BS
H15933Medicare UPIN
WV4213221Medicare PIN