Individual
KHALDOUN FARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY, WORCESTER, MA 01655-0002
(508) 334-3271
(508) 856-5911
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
155502
MA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
155502
MA
207LP2900X
Pain Medicine (Anesthesiology) Physician
155502
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110001675A
—
MA
Enumeration date
10/27/2005
Last updated
11/23/2020
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