Healthcare Provider Details

I. General information

NPI: 1902841596
Provider Name (Legal Business Name): OSAMA HAMDY M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 02/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JOSLIN PL
BOSTON MA
02215-5306
US

IV. Provider business mailing address

7 WEBB AVE
WELLESLEY MA
02481-5415
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-2400
  • Fax: 617-732-2452
Mailing address:
  • Phone: 781-237-6667
  • Fax: 617-732-2452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number213759
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: