Provider Demographics
NPI:1376702449
Name:PAKER, ASIF MAHMOOD (MD, MPH)
Entity Type:Individual
Prefix:
First Name:ASIF
Middle Name:MAHMOOD
Last Name:PAKER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:ASIF
Other - Middle Name:
Other - Last Name:MAHMOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 DORCHESTER AVE
Mailing Address - Street 2:DEPARTMENT OF NEUROLOGY
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-5615
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2100 DORCHESTER AVE
Practice Address - Street 2:DEPARTMENT OF NEUROLOGY
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124-5615
Practice Address - Country:US
Practice Address - Phone:617-564-3771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2017-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10032008207R00000X
TXBP200357882084N0400X
MA2510832084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine