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General NPI Number Information
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NPI Number | 1639279342
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Entity Type | Organization
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Legal Business Name | MAMDOUH RIAD MD PC
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Dates
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Enumeration Date | 09/23/2006
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Last Update Date | 11/28/2025
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Provider Practice Location Address
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Address Line | 51 MAIN ST STE 2
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City | HYANNIS
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State | MA
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Zip | 02601-3109
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Country | US
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Telephone | 508-790-4568
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Fax | 508-865-1109
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Provider Business Mailing Address
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Address Line | 5421 S 88TH ST
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City | LINCOLN
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State | NE
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Zip | 68526-9561
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Country | US
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Telephone | 402-525-4201
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Fax | 508-865-1109
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Authorized Official
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Title or Position | COO
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Name | ASHLEY GOLDSMITH
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Credential |
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Telephone | 402-202-5823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 76855
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License Number State | MA
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