Nabil Abdalla Fam, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

8455-20 Issued in SC

Practice address

324 Mercy St
Lake City, SC 29560-2332

Phone

(843) 374-9945

Fax

(843) 374-5699

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1700834710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 MERCY ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602332",
            "telephone_number": "843-374-9945",
            "fax_number": "843-374-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 MERCY ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602332",
            "telephone_number": "843-374-9945",
            "fax_number": "843-374-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAM",
        "first_name": "NABIL",
        "middle_name": "ABDALLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "8455-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "8455-20",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2860",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa English
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• Sarah Elizabeth Fitch, PT
• Florence County School District Three
• Ashleigh Floyd
• Willa Mae Floyd, RN

• Surgery Physician in Lake City, SC
• Providers in Lake City, SC by specialty
• Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.