Provider Demographics
NPI:1225033673
Name:LABIB, OSSAMA (MD)
Entity Type:Individual
Prefix:
First Name:OSSAMA
Middle Name:
Last Name:LABIB
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 1:1200 ROBESON ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5508
Mailing Address - Country:US
Mailing Address - Phone:508-673-7898
Mailing Address - Fax:
Practice Address - Street 1:1200 ROBESON ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5508
Practice Address - Country:US
Practice Address - Phone:508-673-7898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150378207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAG15617Medicare UPIN
A21121Medicare PIN