Basic Information
| Provider Information | |||||||||
| NPI: | 1306465315 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MELHIM | ||||||||
| FirstName: | ABDULLAH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24 ALTADMON STREET | ||||||||
| Address2: | |||||||||
| City: | SHAFABADRAN, AMMAN | ||||||||
| State: | AMMANN | ||||||||
| PostalCode: | 11934 | ||||||||
| CountryCode: | JO | ||||||||
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| Practice Location | |||||||||
| Address1: | 330 MOUNT AUBURN ST | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021385502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174923500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2020 | ||||||||
| LastUpdateDate: | 04/09/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | MA | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.