Healthcare Provider Details

I. General information

NPI: 1861300840
Provider Name (Legal Business Name): MOHAMMAD JWID DARWEESH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 NEVINS STREET, BOSTON MEDICAL CENTER-BRIGHTON GME MEDICAL OFFICE BUILDING SUITE 304
BOSTON MA
02135
US

IV. Provider business mailing address

WASFI AL TAL STREET, 11953
AMMAN AMMAN
11953
JO

V. Phone/Fax

Practice location:
  • Phone: 617-789-2384
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number3019829
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: