Individual provider · NPI-1

Dr. Ahmad Issam Mahmoud Abualsoud, MBBCH

Otolaryngology · Bethlehem, PA

NPI number1235611005

StatusActive

Last updated in NPPESDec 1, 2022

Details

NPI: 1235611005
Entity type: Individual (NPI-1)
Name: Dr. Ahmad Issam Mahmoud Abualsoud
Credential: MBBCH
Sex: Male
Sole proprietor: Yes
Enumeration date: Aug 29, 2018
Certification date: Dec 1, 2022
Last updated: Dec 1, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207Y00000X	Otolaryngology	MD473596	PA	Yes
207Y00000X	Otolaryngology	MD	PA
207YP0228X	Otolaryngology, Pediatric Otolaryngology	MD473596	PA
390200000X	Student in an Organized Health Care Education/Training Program	–	–

Practice location

3445 High Point Blvd Ste 400
Bethlehem, PA 18017-7817

Phone 610-866-5555 · Fax 610-866-3151

Mailing address

3445 High Point Blvd Ste 400
Bethlehem, PA 18017-7817

Phone 610-866-5555 · Fax 610-866-3151

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