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General NPI Number Information
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NPI Number | 1972726420
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Entity Type | Organization
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Legal Business Name | IQUBAL S. DHALIWAL, M.D.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 10/19/2007
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Provider Practice Location Address
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Address Line | 24 COMMON ST SUITE 3
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City | WRENTHAM
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State | MA
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Zip | 02093-1399
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Country | US
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Telephone | 508-384-1821
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Fax | 508-384-0253
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Provider Business Mailing Address
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Address Line | 24 COMMON ST SUITE 3
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City | WRENTHAM
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State | MA
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Zip | 02093-1399
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Country | US
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Telephone | 508-384-1821
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Fax | 508-384-0253
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Authorized Official
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Title or Position | M.D.
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Name | DR. IQUBAL S. DHALIWAL
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Credential | M.D.
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Telephone | 508-384-1821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 52229
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License Number State | MA
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