Provider Demographics
NPI:1124086095
Name:JABBAR, KHELDA S (MD)
Entity type:Individual
Prefix:DR
First Name:KHELDA
Middle Name:S
Last Name:JABBAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:143 LONGWATER DR
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1683
Mailing Address - Country:US
Mailing Address - Phone:781-878-5200
Mailing Address - Fax:781-878-6750
Practice Address - Street 1:143 LONGWATER DR
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1683
Practice Address - Country:US
Practice Address - Phone:781-878-5200
Practice Address - Fax:781-878-6750
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233696207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1124086095OtherFALLON
042297845OtherHCVM
042297845OtherUNITED HEALTH CARE
1124086095OtherNEIGHBORHOOD HEALTH
AA420247OtherHARVARD PILGRIM HEALTH CARE
042297845OtherGIC-UNICARE
042297845OtherPHCS
MA110078128AOtherMASS HEALTH
9997613OtherCIGNA
042297845OtherTRICARE
MA110078128AMedicaid
1124086095OtherTUFTS HEALTH CARE AND TUFTS MEDICARE PREFERRED
MA1124086095OtherBCBSMA
9546100OtherAETNA
042297845OtherPHCS
1124086095OtherFALLON