Basic Information
| Provider Information | |||||||||
| NPI: | 1023087699 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABBAS | ||||||||
| FirstName: | FOUAD | ||||||||
| MiddleName: | M | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2411 W BELVEDERE AVE | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212155228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106019030 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2411 W BELVEDERE AVE | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212155228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106019030 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2006 | ||||||||
| LastUpdateDate: | 06/12/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | D0038972 | MD | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 122MI1215 | 01 | MD | MEDICARE ID | OTHER |