Provider Demographics
NPI:1114611597
Name:QADADEH, ZIAD MEIEN MOHAMMAD (MD, BCH, BAO)
Entity Type:Individual
Prefix:MR
First Name:ZIAD
Middle Name:MEIEN MOHAMMAD
Last Name:QADADEH
Suffix:
Gender:M
Credentials:MD, BCH, BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 ANASTAS HANNAH STREET, DABOUQ, AMMAN, JORDAN
Mailing Address - Street 2:
Mailing Address - City:AMMAN
Mailing Address - State:AMMAN
Mailing Address - Zip Code:11822
Mailing Address - Country:JO
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:736 CAMBRIDGE STREET, BRIGHTON MA 1ST FLOOR ROOM 115
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-789-2386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3014688207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine