Individual
OMAR ABOUSOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
255 W LANCASTER AVE, PAOLI, PA 19301-1763
(484) 565-1074
Mailing address
PO BOX 678678, DALLAS, TX 75267-8678
(800) 475-6112
(423) 826-1290
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD465946
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2011
Last updated
08/23/2019
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