Provider Demographics
NPI:1679535751
Name:JABBOUR, MUNA N (MD)
Entity type:Individual
Prefix:
First Name:MUNA
Middle Name:N
Last Name:JABBOUR
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 1:512 S CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:NEW STANTON
Mailing Address - State:PA
Mailing Address - Zip Code:15672-9714
Mailing Address - Country:US
Mailing Address - Phone:724-925-1199
Mailing Address - Fax:724-925-6625
Practice Address - Street 1:512 S CENTER AVE
Practice Address - Street 2:
Practice Address - City:NEW STANTON
Practice Address - State:PA
Practice Address - Zip Code:15672-9714
Practice Address - Country:US
Practice Address - Phone:724-925-1199
Practice Address - Fax:724-925-6625
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD063210L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG58694Medicare UPIN
PA901396Medicare PIN