Individual
MOINUDDIN HUDALLIL MUTTAKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
115 MILL ST, BELMONT, MA 02478-1041
(617) 855-2524
Mailing address
20 PARTRIDGE WAY, HOLLISTON, MA 01746-2645
(508) 429-3033
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
53553
MA
2084P0805X
Geriatric Psychiatry Physician
53553
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3100073
—
MA
01
—
J13043
BCBS
MA
Enumeration date
09/23/2006
Last updated
01/12/2022
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