Provider Demographics
NPI:1740592443
Name:ALRADDADI, BASEM MOHAMMED (MD)
Entity Type:Individual
Prefix:DR
First Name:BASEM
Middle Name:MOHAMMED
Last Name:ALRADDADI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:55 STATION LNDG
Mailing Address - Street 2:421
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-5007
Mailing Address - Country:US
Mailing Address - Phone:617-943-7510
Mailing Address - Fax:
Practice Address - Street 1:800 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1552
Practice Address - Country:US
Practice Address - Phone:617-636-7001
Practice Address - Fax:617-636-1580
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA243784207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease