Provider Demographics
NPI:1720318355
Name:ABBOUD, HESHAM AHMED (MD)
Entity type:Individual
Prefix:
First Name:HESHAM
Middle Name:AHMED
Last Name:ABBOUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 TEAL TRCE
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4177
Mailing Address - Country:US
Mailing Address - Phone:216-767-3854
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVENUE, DESK U10
Practice Address - Street 2:CLEVELAND CLINIC
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-2200
Practice Address - Fax:216-636-2989
Is Sole Proprietor?:No
Enumeration Date:2010-01-04
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH1272882084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program