Provider Demographics
NPI:1992756589
Name:ARBOR INPATIENT PHYSICIANS, PC
Entity type:Organization
Organization Name:ARBOR INPATIENT PHYSICIANS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FATHALLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MASHALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-490-2130
Mailing Address - Street 1:42 HEMINGWAY DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-2224
Mailing Address - Country:US
Mailing Address - Phone:401-490-2130
Mailing Address - Fax:
Practice Address - Street 1:76 SUMMER ST
Practice Address - Street 2:ARBOR INPATIENT PHYSICIANS, PC
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-5814
Practice Address - Country:US
Practice Address - Phone:978-372-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9760270Medicaid
MA9760270Medicaid
CTC03531Medicare ID - Type UnspecifiedCT MEDICARE