Individual
MAISOUN ABDELBAQI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 KINGS HWY, DEPARTMENT OF PATHOLOGY, SHREVEPORT, LA 71103-4228
(318) 675-5000
Mailing address
1501 KINGS HWY, DEPARTMENT OF PATHOLOGY, SHREVEPORT, LA 71103-4228
(318) 675-5000
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
84263
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01045
—
LA
05
—
1770784894
—
WI
Enumeration date
05/29/2007
Last updated
09/11/2024
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