Maha Ahmed Bahammam
Individual provider Active NPI Periodontics · Malden, MA
NPI 1013140417 · NPPES record last updated Sep 1, 2009
Key facts
- NPI
- 1013140417
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Periodontics 1223P0300X
- License
- DL10743 (MA)
- Practice address
- 20 Summer St
# 205
Malden, MA 02148-3909 - Phone
- (781) 888-5689
- NPI assigned
- Sep 1, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DL10743 | MA | MD | Periodontist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DL10743 | MA | Yes |
Addresses
Primary practice location
20 Summer St
# 205
Malden, MA 02148-3909
Mailing address
20 Summer St
# 205
Malden, MA 02148-3909
Phone (781) 888-5689
Other providers in Malden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.