Provider Demographics
NPI:1265848907
Name:AWIDI, BUSHRA (MD)
Entity Type:Individual
Prefix:DR
First Name:BUSHRA
Middle Name:
Last Name:AWIDI
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 1:830 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:POCASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02559-2110
Mailing Address - Country:US
Mailing Address - Phone:508-564-9600
Mailing Address - Fax:
Practice Address - Street 1:830 COUNTY RD
Practice Address - Street 2:
Practice Address - City:POCASSET
Practice Address - State:MA
Practice Address - Zip Code:02559-2110
Practice Address - Country:US
Practice Address - Phone:508-564-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2735222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry