Basic Information
| Provider Information | |||||||||
| NPI: | 1669925327 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GELAIDAN | ||||||||
| FirstName: | ABDULHADI | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 E MOUNTAIN ST APT 280 | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016061227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3127140856 | ||||||||
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| Practice Location | |||||||||
| Address1: | 123 SUMMER ST | ||||||||
| Address2: | INTERNAL MEDICINE | ||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016081216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083636208 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2016 | ||||||||
| LastUpdateDate: | 07/29/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 267928 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.