Provider Demographics
NPI:1073595260
Name:ALZAIM, ABOUALKHEIR (MD)
Entity Type:Individual
Prefix:
First Name:ABOUALKHEIR
Middle Name:
Last Name:ALZAIM
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 1:91 CHRISTINA DR
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-8265
Mailing Address - Country:US
Mailing Address - Phone:781-340-6420
Mailing Address - Fax:781-340-6421
Practice Address - Street 1:540 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1818
Practice Address - Country:US
Practice Address - Phone:781-340-6420
Practice Address - Fax:781-340-6421
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50343207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY02665OtherMEDICARE PTAN
00022617OtherBOSTON MED ETC
AA10005OtherHARVARD PILGRIM
MAJ18588OtherBCBS
0020253OtherNEIGHBORHOOD HLTH
MA050343OtherTUFTS
290014917OtherPALMETTO GBA RAILROAD MED
MA3150496Medicaid
MAY02665OtherMEDICARE PTAN
F09091Medicare UPIN