MEDICARE: FADI F AL-BILBEISI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	81030	MA

General Provider Information

NPI Number	:	1205881620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FADI F AL-BILBEISI M.D.

Provider Business Mailing Address
First Line	:	16 LINDA ST
Second Line	:
City	:	LINCOLN
State	:	RI
Zip	:	02865-2216
Country	:	US
Telephone Number	:	401-369-3657
Fax Number	:

Provider Business Practice Location Address
First Line	:	63 EDDIE DOWLING HWY
Second Line	:	SUITE 3
City	:	NORTH SMITHFIELD
State	:	RI
Zip	:	02896-7322
Country	:	US
Telephone Number	:	401-369-3657
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	11/09/2007

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