Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | D0038972 | MD |
NPI | 1023087699 |
---|---|
Provider Name | Fouad M Abbas |
First Address | Baltimore, MD 21215-5228 |
Second Address | Baltimore, MD 21215-5228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 12/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
122MI1215 | MEDICARE ID (01) | MD |
E47782 | (02) | MD |