Provider Demographics
NPI:1396736708
Name:RIAD, DAHLIA (MD)
Entity type:Individual
Prefix:
First Name:DAHLIA
Middle Name:
Last Name:RIAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 N BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:EAST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-1148
Mailing Address - Country:US
Mailing Address - Phone:508-350-2350
Mailing Address - Fax:508-350-2318
Practice Address - Street 1:673 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:MA
Practice Address - Zip Code:02351-1921
Practice Address - Country:US
Practice Address - Phone:781-878-1903
Practice Address - Fax:781-982-0387
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154486207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMX2420OtherMEDICARE PTAN
G82244Medicare UPIN
A28959Medicare ID - Type Unspecified