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Individual

FADLALLAH G HABR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
375 WAMPANOAG TRL, SUITE 202A, RIVERSIDE, RI 02915-2212
(401) 649-4030
(401) 649-4031
Mailing address
17 VIRGINIA AVE, SUITE 107, PROVIDENCE, RI 02905-4406
(401) 443-4992
(401) 784-4902

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD09914
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9021243
RI
Enumeration date
05/27/2006
Last updated
07/27/2016
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