Individual
ALI KHODABANDEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 HOSPITAL ROAD, STE. 2A, LEOMINSTER, MA 01453
(617) 522-8110
Mailing address
P.O. BOX 726, LEOMINSTER, MA 01453
(978) 466-2692
(978) 466-4754
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
242004.
MA
207RP1001X
Pulmonary Disease Physician
Primary
242004.
MA
390200000X
Student in an Organized Health Care Education/Training Program
231041
MA
Other
Enumeration date
09/13/2007
Last updated
02/12/2013
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