Individual
MAIS ABDOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 WEST AVE S, LA CROSSE, WI 54601-8806
(608) 785-0940
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(608) 785-0940
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
4351047087
MI
207RP1001X
Pulmonary Disease Physician
4351047087
MI
207RP1001X
Pulmonary Disease Physician
Primary
82029
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2017
Last updated
06/14/2023
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