Provider Demographics
NPI:1194830455
Name:JABBOUR, NABIL (MD)
Entity Type:Individual
Prefix:
First Name:NABIL
Middle Name:
Last Name:JABBOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 HARVEY AVE # A
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-1994
Mailing Address - Country:US
Mailing Address - Phone:724-832-9378
Mailing Address - Fax:724-473-3297
Practice Address - Street 1:337 HARVEY AVE # A
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1994
Practice Address - Country:US
Practice Address - Phone:724-832-9378
Practice Address - Fax:724-832-9384
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028428E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009638790001Medicaid
PAB41044Medicare UPIN
PA193874Medicare ID - Type Unspecified