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NPI Code Detail

MEDICARE: ABOUD AFFI M.D.

MEDICARE: ABOUD AFFI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician35075WI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00941424OTHERWIRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003891250
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABOUD AFFI M.D.
Provider Business Mailing Address
First Line : 3003 W GOOD HOPE RD
Second Line :
City : MILWAUKEE
State : WI
Zip : 53209-2042
Country : US
Telephone Number : 414-352-3100
Fax Number :
Provider Business Practice Location Address
First Line : 1218 W KILBOURN AVE
Second Line : SUITE 404
City : MILWAUKEE
State : WI
Zip : 53233-1330
Country : US
Telephone Number : 414-291-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 11/18/2021

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