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General NPI Number Information
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NPI Number | 1710218722
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Entity Type | Organization
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Legal Business Name | MICHELLE ABOUD INTERNAL MEDICINE PLLC
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Dates
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Enumeration Date | 01/15/2010
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Last Update Date | 05/02/2022
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Provider Practice Location Address
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Address Line | 710 BRECKENRIDGE LANE SUITE 202
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City | LOUISVILLE
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State | KY
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Zip | 40207
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Country | US
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Telephone | 502-473-8065
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Fax | 502-473-8066
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Provider Business Mailing Address
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Address Line | 710 BRECKENRIDGE LANE SUITE 202
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City | LOUISVILLE
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State | KY
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Zip | 40207
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Country | US
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Telephone | 502-473-8065
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Fax | 502-473-8066
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHELLE ABOUD
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Credential | MD
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Telephone | 502-473-8065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35948
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License Number State | KY
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