Dr. Boutros Michel Ghassibi
Internist Family Doctor - Sports Medicine
34 Haverhill St
Lawrence
, Massachusetts 01841-2884
Dr. Boutros Michel Ghassibi
Internist Family Doctor - Sports Medicine
34 Haverhill St
Lawrence
, Massachusetts 01841-2884
(978) 681-5963
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About
Features
Specialties
- Family Doctor - Sports Medicine
- Internist
Languages spoken
- English
Location
First Address
- Dr. Boutros Michel Ghassibi
- 34 Haverhill St
- Lawrence, MA
- Zip : 01841-2884
- Fax : (978) 681-5963
- Phone : (978) 686-0090
Second Address
- Dr. Boutros Michel Ghassibi
- 34 Haverhill St
- Lawrence, MA
- Zip : 01841-2884
- Fax : (978) 681-5963
- Phone : (978) 686-0090
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | 72138 | MA |
| N | 207R00000X | Internist | 72138 | MA |
| N | 111NI0900X | Internist | 72138 | MA |
National Provider Identifier
| NPI | 1184723819 |
|---|---|
| Provider Name | Dr. Boutros Michel Ghassibi |
| First Address | Lawrence, MA 01841-2884 |
| Second Address | Lawrence, MA 01841-2884 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/09/2006 |
| Last Update Date | 09/11/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 3166724 | (05) | MA |
| E39900 | (02) | MA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.