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Provider Information for 1881688901

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. MICHEL N FAYAD MD

Gender: MALE

Individual NPI: 1881688901

Calendar   Last Updated:  2012-12-21
  Certification Date: 

Details

Name Value
NPI 1881688901
Enumeration Date 2005-09-02
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE FEGAN 11
BOSTON, MA 02115-5724
United States

Phone: 617-355-6388 | Fax: 617-730-0284
View Map External Link
Primary Practice Address 300 LONGWOOD AVE FEGAN 11
BOSTON, MA 02115-5724
United States

Phone: 617-355-6388 | Fax: 617-730-0284
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other MEDICAL LICENSE MA 208387
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 2084N0402X - Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology MA 208387