Samah Abdallah, MD

Individual provider Active NPI Internal Medicine Physician · Brighton, MA

NPI 1730814971 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1730814971
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
293965 (MA)
Practice address
736 Cambridge St
Brighton, MA 02135-2907
Phone
(617) 779-6342
NPI assigned
Jul 21, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250604002532 MI Order and Referring Only - Pulmonary Disease
Practitioner - Pulmonary Disease
9537603030

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
293965MAMDInternal Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 293965 MA Yes

Addresses

Primary practice location

736 Cambridge St
Brighton, MA 02135-2907

Mailing address

1568 Commonwealth Ave Apt 11
Brighton, MA 02135-5009
Phone (315) 450-5687

Other providers in Brighton, MA

All providers in Brighton, MA · Internal Medicine Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.