Healthcare Provider Details

I. General information

NPI: 1427638014
Provider Name (Legal Business Name): ANTOINETTE ABBAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 04/09/2021
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TOWER BUILDING SUITE 2100 2041 GEORGIA AVE. NW
WASHINGTON DC
20060
US

IV. Provider business mailing address

TOWER BUILDING SUITE 2100 2041 GEORGIA AVE. NW
WASHINGTON DC
20060
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-1257
  • Fax:
Mailing address:
  • Phone: 202-865-1257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: