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Individual

GREGORY M ABBAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3515 POPLAR LEVEL RD, LOUISVILLE, KY 40213-1009
(502) 459-3760
(502) 459-3717
Mailing address
2944 BRECKENRIDGE LN, LOUISVILLE, KY 40220-1409
(502) 893-0159
(502) 213-3853

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
319958
KY
207Y00000X
Otolaryngology Physician
Primary
31995
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000223729
BCBS
KY
01
61-0719349
TAX ID
KY
05
64017916
KY
Enumeration date
06/21/2005
Last updated
11/29/2022
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