Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 280092 | MA |
NPI | 1942575147 |
---|---|
Provider Name | Dr. Ahmad Fouad Bayomy |
First Address | Springfield, MA 01104-2396 |
Second Address | Springfield, MA 01104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2012 |
Last Update Date | 10/10/2019 |