Provider Demographics
NPI:1457353781
Name:ABDEL NOUR, MAGDY WAGUIH (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGDY
Middle Name:WAGUIH
Last Name:ABDEL NOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 N 7TH ST
Mailing Address - Street 2:STE 109
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-1057
Mailing Address - Country:US
Mailing Address - Phone:812-242-9631
Mailing Address - Fax:812-242-9647
Practice Address - Street 1:1530 N 7TH ST
Practice Address - Street 2:STE 109
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47807-1057
Practice Address - Country:US
Practice Address - Phone:812-242-9631
Practice Address - Fax:812-242-9647
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059070A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200384680Medicaid
IN000000331666OtherANTHEM LPI
IN000000331666OtherANTHEM LPI
INP00140535Medicare PIN
IN200384680Medicaid