Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 073285 | GA |
N | 208600000X | Surgeon | 073285 | GA |
N | 208200000X | Surgeon | 209619 | MA |
N | 208600000X | Surgeon | 209619 | MA |
N | 2086S0102X | Surgical Critical Care | 073285 | GA |
Y | 2086S0102X | Surgical Critical Care | 209619 | MA |
N | 2086S0127X | Trauma Surgeon | 073285 | GA |
NPI | 1295035210 |
---|---|
Provider Name | Assad Taha |
First Address | Burlington, MA 01805-0001 |
Second Address | Burlington, MA 01805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2010 |
Last Update Date | 23/07/2018 |