Healthcare Provider Details

I. General information

NPI: 1205368883
Provider Name (Legal Business Name): FOUAD JABBOUR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2017
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 S WASHINGTON AVE
GREENSBURG PA
15601-2768
US

IV. Provider business mailing address

44 S WASHINGTON AVE
GREENSBURG PA
15601-2768
US

V. Phone/Fax

Practice location:
  • Phone: 724-836-1862
  • Fax: 724-689-0543
Mailing address:
  • Phone: 724-836-1862
  • Fax: 724-689-0543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD474788
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD474788
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: