Provider Demographics
NPI:1053007492
Name:KILIC, ABDULLAH
Entity type:Individual
Prefix:
First Name:ABDULLAH
Middle Name:
Last Name:KILIC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 BINKLEY FARM RD
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-8667
Mailing Address - Country:US
Mailing Address - Phone:336-705-2145
Mailing Address - Fax:
Practice Address - Street 1:1645 BINKLEY FARM RD
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-8667
Practice Address - Country:US
Practice Address - Phone:336-705-2145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program