Provider Demographics
NPI:1386612026
Name:ABBED, KHALID M (MD)
Entity type:Individual
Prefix:DR
First Name:KHALID
Middle Name:M
Last Name:ABBED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2660 MAIN ST STE 219
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-5301
Mailing Address - Country:US
Mailing Address - Phone:860-332-3272
Mailing Address - Fax:
Practice Address - Street 1:333 CEDAR ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3206
Practice Address - Country:US
Practice Address - Phone:203-785-2807
Practice Address - Fax:203-737-1486
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT045775207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0C97618OtherBCBSM
MI4930983Medicaid
MA403950OtherTUFTS HEALTH PLAN
MA2112299Medicaid
MI4930983Medicaid