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General NPI Number Information
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NPI Number | 1386609907
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Entity Type | Individual
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Provider Name | FATHALLA MASHALI MD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 10 CONVERSE PL SUITE 4
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City | WINCHESTER
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State | MA
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Zip | 01890-2713
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Country | US
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Telephone | 781-729-0500
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Fax | 781-729-0581
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Provider Business Mailing Address
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Address Line | 10 CONVERSE PL SUITE 4
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City | WINCHESTER
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State | MA
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Zip | 01890-2713
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Country | US
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Telephone | 781-729-0500
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Fax | 781-729-0581
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 152670
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD09332
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 152670
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | MD09332
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License Number State | RI
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