Healthcare Provider Details

I. General information

NPI: 1518946607
Provider Name (Legal Business Name): FOWZAN S ALKURAYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE FEGAN 10
BOSTON MA
02115-5724
US

IV. Provider business mailing address

77 AVENUE LOUIS PASTEUR NRB 458
BOSTON MA
02115-5727
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-6000
  • Fax: 617-525-4751
Mailing address:
  • Phone: 617-525-4710
  • Fax: 617-525-4751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number220648
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number220648
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: