Individual
SYED M IMAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 LIBERTY ST, BROCKTON, MA 02301-5521
(508) 894-0400
(508) 894-0412
Mailing address
110 LIBERTY ST, BROCKTON, MA 02301-5521
(508) 894-0400
(508) 894-0412
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
234647
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2153165
—
MA
Enumeration date
01/14/2008
Last updated
01/12/2024
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