MEDICARE: SALAH ALRAKAWI 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	207R00000X	Internal Medicine Physician	154525	MA

General Provider Information

NPI Number	:	1760467526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALAH ALRAKAWI MD

Provider Business Mailing Address
First Line	:	170 MORTON ST
Second Line	:
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-3735
Country	:	US
Telephone Number	:	617-522-8110
Fax Number	:	617-971-3852

Provider Business Practice Location Address
First Line	:	301 S HUNTINGTON AVE
Second Line	:
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-4807
Country	:	US
Telephone Number	:	857-307-3300
Fax Number	:

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

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	12/12/2019

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