Provider Demographics
NPI:1134531981
Name:MORAD, NADIA MUHAMMAD
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:MUHAMMAD
Last Name:MORAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 SIMEON HOWARD WAY
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1883
Mailing Address - Country:US
Mailing Address - Phone:978-552-8068
Mailing Address - Fax:
Practice Address - Street 1:10010 SHOPS WAY # H
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-4118
Practice Address - Country:US
Practice Address - Phone:508-466-2223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856523122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist