Provider Demographics
NPI:1790163434
Name:TRABOULSI, HENRI TOUFIC (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRI
Middle Name:TOUFIC
Last Name:TRABOULSI
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 1:331 JUSTISON ST
Mailing Address - Street 2:APT 403
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-5181
Mailing Address - Country:US
Mailing Address - Phone:313-467-3631
Mailing Address - Fax:
Practice Address - Street 1:331 JUSTISON ST
Practice Address - Street 2:APT 403
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-5181
Practice Address - Country:US
Practice Address - Phone:313-467-3631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-14
Last Update Date:2017-11-17
Deactivation Date:2015-12-23
Deactivation Code:
Reactivation Date:2016-02-25
Provider Licenses
StateLicense IDTaxonomies
TX45841207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology