Individual
BILAL FAWAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
725 ALBANY ST # 8B, BOSTON, MA 02118-3549
(617) 638-7420
(617) 638-7289
Mailing address
960 MASSACHUSETTS AVENUE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
285459
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110164584A
—
MA
05
—
3135073
—
NH
Enumeration date
06/09/2016
Last updated
03/21/2025
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