Provider Demographics
NPI:1851387799
Name:HAMADA, FAISAL S (MD)
Entity Type:Individual
Prefix:
First Name:FAISAL
Middle Name:S
Last Name:HAMADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:145 WHITTIER RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-3736
Mailing Address - Country:US
Mailing Address - Phone:617-322-1544
Mailing Address - Fax:617-322-1544
Practice Address - Street 1:830 OAK ST
Practice Address - Street 2:SUITE 105W
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1168
Practice Address - Country:US
Practice Address - Phone:508-897-4767
Practice Address - Fax:508-897-4770
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA156327207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0101265Medicaid
MA0101265Medicaid
MAA30967Medicare ID - Type Unspecified