Provider Demographics
NPI:1376597427
Name:HAJ-DARWISH, YUSEF (MD)
Entity Type:Individual
Prefix:
First Name:YUSEF
Middle Name:
Last Name:HAJ-DARWISH
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 1:4 MERCER RD
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-2415
Mailing Address - Country:US
Mailing Address - Phone:508-318-4466
Mailing Address - Fax:508-545-1445
Practice Address - Street 1:1210 BOSTON PROVIDENCE TPKE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5061
Practice Address - Country:US
Practice Address - Phone:781-255-0500
Practice Address - Fax:781-255-0400
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155855207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ21693OtherBLUE SHIELD
MA3201163Medicaid
MAJ21693OtherBLUE SHIELD
MA3201163Medicaid
MAOX1118Medicare PIN
MAA30087Medicare PIN