Individual
DR. FARES GEORGES MOUCHANTAF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
LAHEY HOSPITAL AND MEDICAL CENTER, 41 MALL ROAD, BURLINGTON, MA 01805-0001
(781) 744-8480
(781) 744-3443
Mailing address
LAHEY HOSPITAL AND MEDICAL CENTER, 41 MALL ROAD, BURLINGTON, MA 01805-0001
(781) 744-8480
(781) 744-3443
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
225515
MA
207RP1001X
Pulmonary Disease Physician
Primary
225515
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110075967A
—
MA
Enumeration date
02/20/2007
Last updated
03/19/2019
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