Basic Information
| Provider Information | |||||||||
| NPI: | 1881794493 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALABDULRAZZAQ | ||||||||
| FirstName: | HAMAD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 526 MAIN ST | ||||||||
| Address2: | SUITE 302 | ||||||||
| City: | ACTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017203301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9788497507 | ||||||||
| FaxNumber: | 9783710522 | ||||||||
| Practice Location | |||||||||
| Address1: | 87 MCGREGOR ST | ||||||||
| Address2: | SUITE 2100 | ||||||||
| City: | MANCHESTER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031023765 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036267546 | ||||||||
| FaxNumber: | 6036267548 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2006 | ||||||||
| LastUpdateDate: | 10/07/2016 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 07/17/2007 | ||||||||
| NPIReactivationDate: | 09/25/2007 | ||||||||
| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | ME96825 | FL | N | Allopathic & Osteopathic Physicians | Dermatology | 207ND0101X | ME96825 | FL | N | Allopathic & Osteopathic Physicians | Dermatology | MOHS-Micrographic Surgery | 207NP0225X | ME96825 | FL | N | Allopathic & Osteopathic Physicians | Dermatology | Pediatric Dermatology | 207NS0135X | ME96825 | FL | N | Allopathic & Osteopathic Physicians | Dermatology | Procedural Dermatology | 207ND0101X | 13940 | NH | Y | Allopathic & Osteopathic Physicians | Dermatology | MOHS-Micrographic Surgery | 207ND0101X | 265468 | MA | N | Allopathic & Osteopathic Physicians | Dermatology | MOHS-Micrographic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 58357 | 01 | FL | BLUE SHIELD | OTHER | 0671642 | 01 | FL | CIGNA | OTHER | 276996400 | 05 | FL | MEDICAID | 304790 | 01 | FL | AVMED | OTHER |