MEDICARE: DR. MOHAMAD R EL-ZARU MD

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	207RI0011X	Interventional Cardiology Physician	157222	MA
2	207RC0000X	Cardiovascular Disease Physician	157222	MA

General Provider Information

NPI Number	:	1366440794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMAD R EL-ZARU MD

Provider Business Mailing Address
First Line	:	31 PINE ST
Second Line	:
City	:	NORFOLK
State	:	MA
Zip	:	02056-1642
Country	:	US
Telephone Number	:	508-623-3700
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 PINE ST
Second Line	:
City	:	NORFOLK
State	:	MA
Zip	:	02056-1642
Country	:	US
Telephone Number	:	508-623-3700
Fax Number	:

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

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	10/07/2021

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