Individual
STEPHANIE BOU-ABBOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 S CLINTON ST, BALTIMORE, MD 21224-5730
(410) 605-2558
Mailing address
1501 S CLINTON ST, BALTIMORE, MD 21224-5730
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
R207815
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AAG9112
COMMERCIAL INSURANCE
—
Enumeration date
07/06/2022
Last updated
07/06/2022
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