Provider Demographics
NPI:1881794493
Name:ALABDULRAZZAQ, HAMAD (MD)
Entity type:Individual
Prefix:DR
First Name:HAMAD
Middle Name:
Last Name:ALABDULRAZZAQ
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 1:526 MAIN ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3301
Mailing Address - Country:US
Mailing Address - Phone:978-849-7507
Mailing Address - Fax:978-371-0522
Practice Address - Street 1:87 MCGREGOR ST
Practice Address - Street 2:SUITE 2100
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3765
Practice Address - Country:US
Practice Address - Phone:603-626-7546
Practice Address - Fax:603-626-7548
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2016-10-07
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-09-25
Provider Licenses
StateLicense IDTaxonomies
FLME96825207N00000X, 207ND0101X, 207NP0225X, 207NS0135X
NH13940207ND0101X
MA265468207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL58357OtherBLUE SHIELD
FL0671642OtherCIGNA
FL276996400Medicaid
FL304790OtherAVMED
FL58357OtherBLUE SHIELD
NHT400259447Medicare PIN
FL304790OtherAVMED
I64134Medicare UPIN