Organization
HEALTHDRIVE PODIATRY GROUP, PC
Active
Other names
HealthDrive Podiatry Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHADI ADIB ABBOUD DPM (TREASURER/PRACTICE DIRECTOR)
(857) 255-0486
Entity
Organization
Contact information
Practice address
200 S EXECUTIVE DR, SUITE 101, BROOKFIELD, WI 53005-4216
(414) 535-8134
(414) 535-8135
Mailing address
100 CROSSING BLVD, SUITE 300, FRAMINGHAM, MA 01702-5555
(617) 964-6681
(339) 686-2561
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43264300
—
WI
01
—
CD2116
MEDICARE RAILROAD
WI
Enumeration date
07/06/2006
Last updated
04/16/2020
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