Healthcare Provider Details

I. General information

NPI: 1952995185
Provider Name (Legal Business Name): DR. MARWA FAROUK ELMAHDI ABDRABBOU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2021
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 MAPLEWOOD AVE
WINSTON SALEM NC
27103-3903
US

IV. Provider business mailing address

3155 MAPLEWOOD AVE
WINSTON SALEM NC
27103-3903
US

V. Phone/Fax

Practice location:
  • Phone: 336-718-6230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number13548
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: