Healthcare Provider Details

I. General information

NPI: 1134375157
Provider Name (Legal Business Name): JOSEPH Y ABDAYEM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2008
Last Update Date: 07/13/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2723 S 7TH STREET STE L
TERRE HAUTE IN
47802-3558
US

IV. Provider business mailing address

2723 S 7TH STREET STE A
TERRE HAUTE IN
47802-3558
US

V. Phone/Fax

Practice location:
  • Phone: 812-232-5936
  • Fax: 812-235-1290
Mailing address:
  • Phone: 812-238-1730
  • Fax: 812-242-1565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01069076A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01069076A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: