Provider Demographics
NPI:1770224602
Name:ABOUZID, MOHAMED RIAD (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:RIAD
Last Name:ABOUZID
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 1:508 S SHELBY ST APT F
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3608
Mailing Address - Country:US
Mailing Address - Phone:773-683-8165
Mailing Address - Fax:
Practice Address - Street 1:3282 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4610
Practice Address - Country:US
Practice Address - Phone:409-212-7463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program