Provider Demographics
NPI:1548589690
Name:ABDEL-RAHIM, MUHAMMAD Y (DMD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:Y
Last Name:ABDEL-RAHIM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 ELM ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-1559
Mailing Address - Country:US
Mailing Address - Phone:781-350-8910
Mailing Address - Fax:
Practice Address - Street 1:439 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:INDIAN ORCHARD
Practice Address - State:MA
Practice Address - Zip Code:01151-1239
Practice Address - Country:US
Practice Address - Phone:781-350-8910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1855385122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist