Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 278685 | MA |
Y | 207L00000X | Anesthesiologist | 4301502502 | MI |
N | 208D00000X | General Practice Physician | 130635 | OH |
NPI | 1003201971 |
---|---|
Provider Name | Mousab Eteer |
First Address | Boston, MA 02115-6110 |
Second Address | Detroit, MI 48202-2608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2015 |
Last Update Date | 22/06/2020 |