Provider Demographics
NPI:1568632263
Name:ABBOUD, MICHAEL JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:ABBOUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2500 BERNVILLE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9453
Mailing Address - Country:US
Mailing Address - Phone:610-378-2000
Mailing Address - Fax:610-378-2799
Practice Address - Street 1:2494 BERNVILLE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-9469
Practice Address - Country:US
Practice Address - Phone:610-378-7900
Practice Address - Fax:610-378-1952
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08702900208600000X
PAMD438853208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery