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1093930513

NPI Code Detail

MEDICARE: DR. DORY ABOU JAOUDE MD

MEDICARE: DR. DORY ABOU JAOUDE MD

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
1	207R00000X	Internal Medicine Physician	04-33075	KS
2	207R00000X	Internal Medicine Physician	MD2018-0732	NM

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	003719119	OTHER		MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1093930513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DORY ABOU JAOUDE MD

Provider Business Mailing Address
First Line	:	PO BOX 8035
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67208-0035
Country	:	US
Telephone Number	:	316-689-9135
Fax Number	:	316-689-9667

Provider Business Practice Location Address
First Line	:	3311 E MURDOCK ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67208-3054
Country	:	US
Telephone Number	:	316-268-5000
Fax Number	:	316-291-7897

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	01/13/2026

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Directions to “ DR. DORY ABOU JAOUDE MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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