Healthcare Provider Details

I. General information

NPI: 1124857107
Provider Name (Legal Business Name): JEFFREY ABBOUD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 STILES RD STE 207
SALEM NH
03079-2894
US

IV. Provider business mailing address

32 STILES RD STE 204
SALEM NH
03079-2894
US

V. Phone/Fax

Practice location:
  • Phone: 603-894-9898
  • Fax: 603-894-6270
Mailing address:
  • Phone: 603-894-9898
  • Fax: 603-894-6270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number10479
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: