Provider Demographics
NPI:1053554949
Name:KADDIS, NANCY EL-SHAMAA (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:EL-SHAMAA
Last Name:KADDIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NANCY
Other - Middle Name:NABIL
Other - Last Name:EL-SHAMAA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 COLUMBIAN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1601
Mailing Address - Country:US
Mailing Address - Phone:616-308-8856
Mailing Address - Fax:
Practice Address - Street 1:1575 CAMBRIDGE ST
Practice Address - Street 2:DIVISION OF INTERNAL MEDICINE
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4308
Practice Address - Country:US
Practice Address - Phone:866-600-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA252322207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine