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Organization
WISSAM KHOORY, MD,PC
Active
Organization
WISSAM KHOORY, MD,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE CORMIER (SECRETARY)
(781) 893-4490
Entity
Organization
Contact information
Practice address
20 HOPE AVE, SUITE G03, WALTHAM, MA 02453-2721
(781) 893-4490
(781) 893-1030
Mailing address
20 HOPE AVE, SUITE G03, WALTHAM, MA 02453-2721
(781) 893-4490
(781) 893-1030
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
153969
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J18529
BLUE CROSS
—
Enumeration date
04/01/2008
Last updated
04/01/2008
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