Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DL13095 | MA |
NPI | 1013457290 |
---|---|
Provider Name | Majed Khalid M Alshehri |
First Address | Boston, MA 02215-2522 |
Second Address | Boston, MA 02118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2017 |
Last Update Date | 07/03/2017 |