Individual provider · NPI-1

Abdalla Abouhaib, SO-ATP

Military Health Care Provider, Independent Duty Corpsman · Camp Lejeune, NC

NPI number1063287738
StatusActive
Last updated in NPPESNov 22, 2023

Details

NPI
1063287738
Entity type
Individual (NPI-1)
Name
Abdalla Abouhaib
Credential
SO-ATP
Sex
Male
Sole proprietor
No
Enumeration date
Nov 22, 2023
Certification date
Nov 17, 2023
Last updated
Nov 22, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1710I1002X Military Health Care Provider, Independent Duty Corpsman02238959AANCYes

Practice location

2d Reconnaissance Bn
Pcs 20138
Camp Lejeune, NC 28542-0138

Phone 910-440-7703

Mailing address

2d Reconnaissance Battalion
Pcs Box 20138
Camp Lejeune, NC 28542-0138

Phone 910-440-7703

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