Provider Demographics
NPI:1245693480
Name:ALJUAID, MOSSAB (MBBS)
Entity type:Individual
Prefix:
First Name:MOSSAB
Middle Name:
Last Name:ALJUAID
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 STATION LNDG
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-5180
Mailing Address - Country:US
Mailing Address - Phone:202-725-3359
Mailing Address - Fax:
Practice Address - Street 1:500 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1210
Practice Address - Country:US
Practice Address - Phone:202-725-3359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program