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Individual

NASSER M EL MALLAH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2141 BOSTON RD, WILBRAHAM, MA 01095
(413) 599-4994
(413) 599-4969
Mailing address
PO BOX 2608, SPRINGFIELD, MA 01101
(413) 599-4994
(413) 599-4969

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
219653
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000027963
BOSTON MEDICAL
MA
05
2063191
MA
01
P00120685
RR MEDICARE
MA
Enumeration date
04/19/2006
Last updated
07/08/2007
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