Provider Demographics
NPI:1417919168
Name:EL-KADI, HISHAM S (MD)
Entity Type:Individual
Prefix:DR
First Name:HISHAM
Middle Name:S
Last Name:EL-KADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:690 CANTON STREET
Mailing Address - Street 2:SUITE 325
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-2329
Mailing Address - Country:US
Mailing Address - Phone:781-407-7713
Mailing Address - Fax:
Practice Address - Street 1:585 LEBANON STREET
Practice Address - Street 2:ANESTHETICS OF MASSACHUSETTS, PC
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176
Practice Address - Country:US
Practice Address - Phone:781-979-3000
Practice Address - Fax:401-490-2141
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA151527207L00000X
RIMD12287207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3162028Medicaid
MAG28514Medicare UPIN
MAA21358Medicare ID - Type UnspecifiedMA MEDICARE