Provider Demographics
NPI:1073937405
Name:PYRAMIDS MEDICAL CENTER PC
Entity Type:Organization
Organization Name:PYRAMIDS MEDICAL CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:I
Authorized Official - Last Name:KHEDR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:774-218-5738
Mailing Address - Street 1:110 DEAN ST UNIT 43
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2753
Mailing Address - Country:US
Mailing Address - Phone:774-218-5738
Mailing Address - Fax:
Practice Address - Street 1:110 DEAN ST UNIT 43
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2753
Practice Address - Country:US
Practice Address - Phone:774-218-5738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220474207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty