Provider Demographics
NPI:1386737542
Name:ABOOD, NOEL D (DC)
Entity type:Individual
Prefix:DR
First Name:NOEL
Middle Name:D
Last Name:ABOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6175 SOM CENTER ROAD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2941
Mailing Address - Country:US
Mailing Address - Phone:440-248-5070
Mailing Address - Fax:440-498-4620
Practice Address - Street 1:6175 SOM CENTER ROAD
Practice Address - Street 2:SUITE 140
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2941
Practice Address - Country:US
Practice Address - Phone:440-248-5070
Practice Address - Fax:440-498-4620
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC.1041111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000228017OtherANTHEM
OH000000228017OtherANTHEM/BC/BS
OH000000228017OtherANTHEM
OH9329591Medicare ID - Type Unspecified
T48116Medicare UPIN
OH5881860001Medicare NSC