Individual
JALAL MUKHTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
210 QUINCY AVE, BROCKTON, MA 02302-2862
(508) 894-0400
(508) 894-0617
Mailing address
210 QUINCY AVE, BROCKTON, MA 02302-2862
(508) 894-0400
(508) 894-0617
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT196104
PA
207RR0500X
Rheumatology Physician
Primary
282091
MA
207RR0500X
Rheumatology Physician
MD20142
ME
Other
Enumeration date
07/21/2011
Last updated
06/01/2020
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