Healthcare Provider Details

I. General information

NPI: 1508795329
Provider Name (Legal Business Name): SULEIMAN MOH'D AMJAD SULEIMAN OBEIDAT MBBCH BAO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 ASYLUM AVENUE SUITE 1004, ST FRANCIS HOSPITAL GENGRAS AMBULATORY CARE
HARTFORD CT
06105
US

IV. Provider business mailing address

263 FARMINGTON AVENUE GRADUATE MEDICAL EDUCATION OFFICE UCONN HEALTH
FARMINGTON CT
06030-1921
US

V. Phone/Fax

Practice location:
  • Phone: 860-224-5261
  • Fax:
Mailing address:
  • Phone: 860-679-2147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: