Provider Demographics
NPI:1508360298
Name:ABOUL-FETTOUH, NADER (MD)
Entity type:Individual
Prefix:DR
First Name:NADER
Middle Name:
Last Name:ABOUL-FETTOUH
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 1:1150 N WATTERS RD STE 105
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5536
Mailing Address - Country:US
Mailing Address - Phone:469-331-3242
Mailing Address - Fax:469-331-3243
Practice Address - Street 1:1150 N WATTERS RD STE 105
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5536
Practice Address - Country:US
Practice Address - Phone:469-331-3242
Practice Address - Fax:469-331-3243
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN71383207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery