Provider Demographics
NPI:1134503865
Name:ALFADHEL, ABDULAZIZ SALEH (MD)
Entity type:Individual
Prefix:DR
First Name:ABDULAZIZ
Middle Name:SALEH
Last Name:ALFADHEL
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 1:55 STATION LNDG
Mailing Address - Street 2:APT 507
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-5007
Mailing Address - Country:US
Mailing Address - Phone:617-283-8318
Mailing Address - Fax:
Practice Address - Street 1:55 STATION LNDG
Practice Address - Street 2:APT 507
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-5007
Practice Address - Country:US
Practice Address - Phone:617-283-8318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA263595208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice