Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 269493 | MA |
N | 111NI0900X | Internist | 269493 | MA |
Y | 207SG0201X | Clinical Genetics (M.D.) | 269493 | MA |
N | 207SG0201X | Clinical Genetics (M.D.) | L-259280 | MA |
NPI | 1770990004 |
---|---|
Provider Name | Saud Aldubayan |
First Address | Boston, MA 02115 |
Second Address | Boston, MA 02115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2014 |
Last Update Date | 28/03/2017 |