Healthcare Provider Details

I. General information

NPI: 1588608731
Provider Name (Legal Business Name): JOSEPH ALBERT ABBOUD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CRESCENT DR STE 401
PHILADELPHIA PA
19112-1015
US

IV. Provider business mailing address

833 CHESTNUT ST STE 520
PHILADELPHIA PA
19107-4430
US

V. Phone/Fax

Practice location:
  • Phone: 800-321-9999
  • Fax: 267-479-1321
Mailing address:
  • Phone: 267-562-6191
  • Fax: 267-339-3761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number25MA08009700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberMD072183L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD072183L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: