MEDICARE: DAHLIA RIAD MD

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	207R00000X	Internal Medicine Physician	154486	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MX2420	OTHER	MA	MEDICARE PTAN

General Provider Information

NPI Number	:	1396736708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAHLIA RIAD MD

Provider Business Mailing Address
First Line	:	362 N BEDFORD ST
Second Line	:
City	:	EAST BRIDGEWATER
State	:	MA
Zip	:	02333-1148
Country	:	US
Telephone Number	:	508-350-2350
Fax Number	:	508-350-2318

Provider Business Practice Location Address
First Line	:	673 BEDFORD ST
Second Line	:
City	:	ABINGTON
State	:	MA
Zip	:	02351-1921
Country	:	US
Telephone Number	:	781-878-1903
Fax Number	:	781-982-0387

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

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	03/24/2011

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Directions to “ DAHLIA RIAD MD” Practice Location

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