Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 267222 | MA |
Y | 208600000X | Surgeon | 267222 | MA |
NPI | 1013364686 |
---|---|
Provider Name | Wael Abdullah Alshehri |
First Address | Medford, MA 02155-5007 |
Second Address | Boston, MA 02111-1552 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2016 |
Last Update Date | 24/05/2016 |