Provider Demographics
NPI:1679773931
Name:HAMAM, ROLA NAZIH (MD)
Entity type:Individual
Prefix:
First Name:ROLA
Middle Name:NAZIH
Last Name:HAMAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CAMBRIDGE CTR
Mailing Address - Street 2:FLOOR 8
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02142-1407
Mailing Address - Country:US
Mailing Address - Phone:617-621-6377
Mailing Address - Fax:617-494-1430
Practice Address - Street 1:5 CAMBRIDGE CTR
Practice Address - Street 2:FLOOR 8
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02142-1407
Practice Address - Country:US
Practice Address - Phone:617-621-6377
Practice Address - Fax:617-494-1430
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227508174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist