Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 52089 | MA |
N | 111NI0900X | Internist | 52089 | MA |
Y | 207RG0300X | Geriatric Medicine | 52089 | MA |
NPI | 1023105459 |
---|---|
Provider Name | Saeid Elmi |
First Address | Medford, MA 02155 |
Second Address | Medford, MA 02155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 02/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A57163 | (02) | MA |