Provider Demographics
NPI:1801158910
Name:ABBOUD, JUDITH (MD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:
Last Name:ABBOUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:859 CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:DEALE
Mailing Address - State:MD
Mailing Address - Zip Code:20751-9613
Mailing Address - Country:US
Mailing Address - Phone:443-607-6446
Mailing Address - Fax:
Practice Address - Street 1:1111 20TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20526-0001
Practice Address - Country:US
Practice Address - Phone:202-692-1503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0035722207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine