Individual
DR. EBRAHIM NADEEM GHAZALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1049 MAIN ST, SPRINGFIELD, MA 01103-2114
(413) 739-1100
(413) 735-1133
Mailing address
1049 MAIN ST, SPRINGFIELD, MA 01103-2114
(413) 739-1100
(413) 735-1133
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
295186
MA
208000000X
Pediatrics Physician
R7999
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110168272A
—
MA
01
—
R7999
TEXAS MEDICAL LICENSE
TX
Enumeration date
04/03/2015
Last updated
01/03/2023
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