Organization
HEALTHDRIVE PODIATRY GROUP, PC
Active
Parent organization
HEALTHDRIVE PODIATRY GROUP, PC
Other names
HealthDrive Podiatry Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEALTHDRIVE PODIATRY GROUP, PC
Authorized official
DR. SHADI ADIB ABBOUD DPM (TREASUER/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
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41738600
DME
WI
Enumeration date
10/16/2006
Last updated
01/02/2020
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