Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 287991 | MA |
Y | 208600000X | Surgeon | 287991 | MA |
N | 2086S0102X | Surgical Critical Care | 287991 | MA |
N | 2086S0127X | Trauma Surgeon | 287991 | MA |
NPI | 1134700776 |
---|---|
Provider Name | Dr. Mohammed Abdullah Bawazeer |
First Address | Boston, MA 02111 |
Second Address | Boston, MA 02111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2021 |
Last Update Date | 16/09/2021 |