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Individual

HASSAN ALI ABBOUD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2041 FORT ST, LINCOLN PARK, MI 48146-2402
(313) 603-0102
Mailing address
5404 HILLCREST ST, GLADWIN, MI 48624-8930

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901400525
MI
213ES0103X
Foot & Ankle Surgery Podiatrist
P114204
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A130298019785
DRIVER LICENSE
MI
Enumeration date
05/11/2021
Last updated
10/15/2024
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