Healthcare Provider Details

I. General information

NPI: 1710175583
Provider Name (Legal Business Name): CHARBEL ABOU RJEILY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2007
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 SANDWICH ST
PLYMOUTH MA
02360-2183
US

IV. Provider business mailing address

275 SANDWICH ST
PLYMOUTH MA
02360-2183
US

V. Phone/Fax

Practice location:
  • Phone: 617-754-4677
  • Fax: 617-754-4677
Mailing address:
  • Phone: 617-754-4677
  • Fax: 617-754-4677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number265197
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: