Provider Demographics
NPI:1942712443
Name:ABONDO-MEKOO, GEORGES BUDRY
Entity Type:Individual
Prefix:
First Name:GEORGES
Middle Name:BUDRY
Last Name:ABONDO-MEKOO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29601 JUDITH ST
Mailing Address - Street 2:
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-3416
Mailing Address - Country:US
Mailing Address - Phone:734-469-0071
Mailing Address - Fax:
Practice Address - Street 1:29601 JUDITH ST
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-3416
Practice Address - Country:US
Practice Address - Phone:734-469-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703111843164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse