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Individual

FOUAD S FAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
70 EAST ST, METHUEN, MA 01844-4597
(978) 687-0151
Mailing address
60 EAST ST, STE 1400, METHUEN, MA 01844-4500
(978) 689-4601
(978) 689-3096

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
213312
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0173541
MA
05
30203060
NH
01
414287
TUFT
01
J24937
BCBS
MA
Enumeration date
07/26/2005
Last updated
04/05/2012
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