Provider Demographics
NPI:1386823466
Name:ABBOUD, JULIE ANN (DPM)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:ABBOUD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N1697 MUNICIPAL DR
Mailing Address - Street 2:STE 3
Mailing Address - City:GREENVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54942-7701
Mailing Address - Country:US
Mailing Address - Phone:920-750-7900
Mailing Address - Fax:
Practice Address - Street 1:N1697 MUNICIPAL DR
Practice Address - Street 2:SUITE 3
Practice Address - City:GREENVILLE
Practice Address - State:WI
Practice Address - Zip Code:54942-7700
Practice Address - Country:US
Practice Address - Phone:847-877-4371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300995213ES0103X
WI984-025213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery