Healthcare Provider Details

I. General information

NPI: 1134651656
Provider Name (Legal Business Name): SAM ABDEHOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 SPRING HILL AVE
MOBILE AL
36604-1407
US

IV. Provider business mailing address

1700 SPRING HILL AVE
MOBILE AL
36604-1407
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-1200
  • Fax: 251-435-6355
Mailing address:
  • Phone: 251-435-1200
  • Fax: 251-435-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number51434
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: