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1376612945 NPI number — GEORGE E ABBOUD MD

NPI Number: 1376612945
Health Care Provider/Practitioner: GEORGE E ABBOUD MD

Information about “1376612945” NPI (GEORGE E ABBOUD MD) exists in 1376612945 in HTML format HTML  |  1376612945 in plain Text format TXT  |  1376612945 in PDF (Portable Document Format) PDF  |  1376612945 in an XML format XML  formats.

NPI Number : 1376612945 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1376612945",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ABBOUD",
    "FirstName": "GEORGE",
    "MiddleName": "E",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 950",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BIDDEFORD",
    "MailingAddressStateName": "ME",
    "MailingAddressPostalCode": "04005-0950",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "207-283-4395",
    "MailingAddressFaxNumber": "207-283-1016",
    "FirstLinePracticeLocationAddress": "481 ALFRED ROAD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BIDDEFORD",
    "PracticeLocationAddressStateName": "ME",
    "PracticeLocationAddressPostalCode": "04005-9473",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "207-283-4395",
    "PracticeLocationAddressFaxNumber": "207-283-1016",
    "EnumerationDate": "11/07/2006",
    "LastUpdateDate": "06/09/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "174400000X",
          "TaxonomyName": "Specialist",
          "LicenseNumber": "011277",
          "LicenseNumberStateCode": "ME",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "MD11277",
          "LicenseNumberStateCode": "ME",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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