MEDICARE: OSAMA A. AL-MASRI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	39031	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144216946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSAMA A. AL-MASRI M.D.

Provider Business Mailing Address
First Line	:	80 MECHANIC ST
Second Line	:	1:4
City	:	ATHOL
State	:	MA
Zip	:	01331-3534
Country	:	US
Telephone Number	:	978-249-5668
Fax Number	:	978-249-5669

Provider Business Practice Location Address
First Line	:	80 MECHANIC ST
Second Line	:	1:4
City	:	ATHOL
State	:	MA
Zip	:	01331-3534
Country	:	US
Telephone Number	:	978-249-5668
Fax Number	:	978-249-5669

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	07/08/2007

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