Provider Demographics
NPI:1023105459
Name:ELMI, SAEID (MD)
Entity type:Individual
Prefix:
First Name:SAEID
Middle Name:
Last Name:ELMI
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:170 GOVERNORS AVENUE
Mailing Address - Street 2:HALLMARK HEALTH MEDICAL ASSOCIATES, INC
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155
Mailing Address - Country:US
Mailing Address - Phone:781-979-2424
Mailing Address - Fax:781-338-7557
Practice Address - Street 1:170 GOVERNORS AVENUE
Practice Address - Street 2:HALLMAK HEALTH MEDICAL ASSOCIATES, INC
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155
Practice Address - Country:US
Practice Address - Phone:781-979-2424
Practice Address - Fax:781-338-7557
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2012-05-02
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Provider Licenses
StateLicense IDTaxonomies
MA52089207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMX9522Medicare PIN
MAJ04045Medicare ID - Type Unspecified
MAA57163Medicare UPIN