Provider Demographics
NPI:1003470204
Name:HAMDAN, AHMAD (MD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:HAMDAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WASHINGTON ST # 238
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1552
Mailing Address - Country:US
Mailing Address - Phone:617-636-7010
Mailing Address - Fax:617-636-7100
Practice Address - Street 1:800 WASHINGTON ST # 238
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1552
Practice Address - Country:US
Practice Address - Phone:617-636-7010
Practice Address - Fax:617-636-7100
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2022-07-08
Deactivation Date:2019-12-04
Deactivation Code:
Reactivation Date:2019-12-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program