Provider Demographics
NPI:1316106958
Name:MOUSSA, MOHAMED E (MD)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:E
Last Name:MOUSSA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:MASSACHUSETTS GENERAL HOSPITAL
Mailing Address - Street 2:55 FRUIT ST WHITE #535
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:617-726-2942
Mailing Address - Fax:612-726-3124
Practice Address - Street 1:MASSACHUSETTS GENERAL HOSPITAL
Practice Address - Street 2:55 FRUIT ST WHITE # 535
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-2942
Practice Address - Fax:612-726-3124
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2021-11-30
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Provider Licenses
StateLicense IDTaxonomies
CAA130291207XS0114X
MA252691207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery