Provider Demographics
NPI:1699765776
Name:NORELDIN, MOHSEN M (MD)
Entity type:Individual
Prefix:DR
First Name:MOHSEN
Middle Name:M
Last Name:NORELDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 LYMAN ST STE 20
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2657
Mailing Address - Country:US
Mailing Address - Phone:508-983-4089
Mailing Address - Fax:
Practice Address - Street 1:45 LYMAN ST STE 20
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2657
Practice Address - Country:US
Practice Address - Phone:781-449-3714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152591207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3208036Medicaid
NOA30320Medicare ID - Type Unspecified
MA3208036Medicaid