Individual
DR. OMAR EZZIDDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
908 ALLEN ST, SPRINGFIELD, MA 01118-2533
(413) 796-7494
Mailing address
908 ALLEN ST, SPRINGFIELD, MA 01118-2533
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036131711
IL
207LP3000X
Pediatric Anesthesiology Physician
036131711
IL
Other
Enumeration date
04/21/2009
Last updated
11/27/2023
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