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NPI Code Detail

MEDICARE: OMAR DABDOUB

MEDICARE: OMAR DABDOUB
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1073461190
Entity Type Code : Individual
Provider Name (Legal Business Name) : OMAR DABDOUB
Provider Business Mailing Address
First Line : 1781 CLAYHILL POINTE SW
Second Line :
City : MARIETTA
State : GA
Zip : 30064-6002
Country : US
Telephone Number : 678-764-8573
Fax Number :
Provider Business Practice Location Address
First Line : 1924 ALCOA HWY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37920-1511
Country : US
Telephone Number : 865-305-9290
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2026
Last Update Date : 03/18/2026

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Directions to “ OMAR DABDOUB ” Practice Location

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