Provider Demographics
NPI:1104880475
Name:ABBOUD, GEORGE A (DPM)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:ABBOUD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 NEW CROSSING RD STE 311
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-3271
Mailing Address - Country:US
Mailing Address - Phone:781-944-4044
Mailing Address - Fax:781-944-4050
Practice Address - Street 1:30 NEW CROSSING RD STE 311
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3271
Practice Address - Country:US
Practice Address - Phone:781-944-4044
Practice Address - Fax:781-944-4050
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2214213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA8149109OtherCIGNA
MAY71118OtherBLUE CROSS BLUE SHIELD
MA470022OtherTUFTS HEALTH CARE
MA0364860Medicaid
MA0032914OtherNEIGHBOORHOOD HEALTH PLAN
MAAA14775OtherHARVARD PILGRIM HELATHCAR
MAY71118OtherBLUE CROSS\BLUE SHIELD
Y75144Medicare ID - Type Unspecified