Provider Demographics
NPI:1225007313
Name:ALAM, GHAZALA E (MD)
Entity Type:Individual
Prefix:MS
First Name:GHAZALA
Middle Name:E
Last Name:ALAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COURTHOUSE LN
Mailing Address - Street 2:SUITE 13/15
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1738
Mailing Address - Country:US
Mailing Address - Phone:978-452-0052
Mailing Address - Fax:978-452-2205
Practice Address - Street 1:1 COURTHOUSE LN
Practice Address - Street 2:SUITE 13/15
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1738
Practice Address - Country:US
Practice Address - Phone:978-452-0052
Practice Address - Fax:978-452-2205
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA158508207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine