Provider Demographics
NPI:1730283607
Name:ENTEKHABI, FATEMEH (MD)
Entity Type:Individual
Prefix:
First Name:FATEMEH
Middle Name:
Last Name:ENTEKHABI
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 1:2 CHESTNUT ST
Mailing Address - Street 2:#24
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4847
Mailing Address - Country:US
Mailing Address - Phone:617-901-7252
Mailing Address - Fax:
Practice Address - Street 1:2 CHESTNUT ST
Practice Address - Street 2:#24
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4847
Practice Address - Country:US
Practice Address - Phone:617-901-7252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230149207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease