Provider Demographics
NPI:1922150804
Name:ATTIA-HANNA, RAAFAT I (MD)
Entity Type:Individual
Prefix:DR
First Name:RAAFAT
Middle Name:I
Last Name:ATTIA-HANNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 LONG POND RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2642
Mailing Address - Country:US
Mailing Address - Phone:508-747-0041
Mailing Address - Fax:508-747-0059
Practice Address - Street 1:110 LONG POND RD
Practice Address - Street 2:SUITE 110
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2642
Practice Address - Country:US
Practice Address - Phone:508-747-0041
Practice Address - Fax:508-747-0059
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA72108207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM16740OtherBLUE CROSS BBLUE SHIELD
MA1881870525OtherAETNA
MA072108OtherTUFTS
MA9781706Medicaid
MA1881870525OtherAETNA
MAM16740OtherBLUE CROSS BBLUE SHIELD