Provider Demographics
NPI:1639128150
Name:DOUEK, ABIGAIL W (PT)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:W
Last Name:DOUEK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N WEST ST
Mailing Address - Street 2:STE 121
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-1399
Mailing Address - Country:US
Mailing Address - Phone:919-520-3505
Mailing Address - Fax:
Practice Address - Street 1:401 N WEST ST
Practice Address - Street 2:STE 121
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1399
Practice Address - Country:US
Practice Address - Phone:919-520-3505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10118225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2508302Medicare ID - Type Unspecified