Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN1858221 | MA |
Y | 213EG0000X | General Practice | DN1858221 | MA |
N | 204E00000X | Oral & Maxillofacial Surgeon | DL13643 | MA |
NPI | 1427543610 |
---|---|
Provider Name | Sama E Abdul-Aziz |
First Address | Boston, MA 02114-2750 |
Second Address | Boston, MA 02114-2750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2018 |
Last Update Date | 03/06/2021 |