Provider Demographics
NPI:1831189364
Name:EL ABD, OMAR HAMMAM (MD)
Entity type:Individual
Prefix:DR
First Name:OMAR
Middle Name:HAMMAM
Last Name:EL ABD
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 1:378 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-6207
Mailing Address - Country:US
Mailing Address - Phone:781-489-5541
Mailing Address - Fax:781-489-5340
Practice Address - Street 1:378 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-6207
Practice Address - Country:US
Practice Address - Phone:781-489-5541
Practice Address - Fax:781-489-5340
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMD217195208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA35394Medicare ID - Type Unspecified
H62115Medicare UPIN
MA217195OtherTUFTS HEALTH PLAN
MAA35394Medicare ID - Type Unspecified
MA2007151Medicaid