Provider Demographics
NPI:1770990004
Name:ALDUBAYAN, SAUD (MBBS)
Entity type:Individual
Prefix:
First Name:SAUD
Middle Name:
Last Name:ALDUBAYAN
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:CHILDRENS HOSPITAL
Mailing Address - Street 2:300 LONGWOOD AVE.
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-726-1742
Mailing Address - Fax:
Practice Address - Street 1:CHILDRENS HOSPITAL
Practice Address - Street 2:300 LONGWOOD AVE.
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-726-1742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-259280207SG0201X
MA269493207SG0201X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine