Provider Demographics
NPI:1528228947
Name:ABDALLAH, ELIE G (MD)
Entity Type:Individual
Prefix:
First Name:ELIE
Middle Name:G
Last Name:ABDALLAH
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 1:562 SHEARER ST
Mailing Address - Street 2:MEDICAL ARTS BUILDING, SUITE 203
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-2746
Mailing Address - Country:US
Mailing Address - Phone:724-837-1894
Mailing Address - Fax:724-837-0681
Practice Address - Street 1:562 SHEARER ST
Practice Address - Street 2:MEDICAL ARTS BUILDING, SUITE 203
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2746
Practice Address - Country:US
Practice Address - Phone:724-837-1894
Practice Address - Fax:724-837-0681
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD433976174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist