MEDICARE: DR. ELIAS ABDALLAH ABOU-JAOUDE MD

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
1	207R00000X	Internal Medicine Physician	4301512635	MI
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1457932519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIAS ABDALLAH ABOU-JAOUDE MD

Provider Business Mailing Address
First Line	:	462 GRIDER ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14215-3021
Country	:	US
Telephone Number	:	716-898-4578
Fax Number	:	716-898-3279

Provider Business Practice Location Address
First Line	:	462 GRIDER ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14215-3021
Country	:	US
Telephone Number	:	716-898-4578
Fax Number	:	716-898-3279

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2021
Last Update Date	:	05/21/2026

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